2Z3-94018-65853
3 vaccinations
7 coded responses
35 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 190 / PA
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Registered in v-safe
-
2021-01-20
Dose 1 — Moderna
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2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Redness · Muscle or body achesFree text: Same four hives I get after the flu shot every year likely attributed to the adjuvant.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Hypersensitivity, Urticaria — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: Four hives same as those I get after annual flu shot. Assume its a mild allergic reaction to the adjuvant.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Urticaria — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: Fading hives under arms I always get after flu shot as well. Probably mild allergy to component of adjuvant. Maybe a preservative (formaldehyde releaser?)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-02-03
- 2021-02-10
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2021-02-17
Dose 2 — Moderna
- 2021-02-17
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2021-02-18
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Urticaria, Vaccine positive rechallenge — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection siteFree text: 4 large hives which I always get after any vaccine. Excipients?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-20
Survey response — days 1–6 daily, dose 2MedDRA: Reaction to previous exposure to any vaccine, Urticaria — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Four hives that I always get after every vaccine. Probably excipient related.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Urticaria — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Fading hives.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-05-19
- 2021-08-18
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2021-10-31
Dose 3 — Moderna
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2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activitiesAdult check-in
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2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
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2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-11-04
- 2021-11-05
- 2021-11-07
- 2021-11-14
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2021-11-21
Survey response — day 21, dose 3MedDRA: Fatigue, Pain — Feeling: FairFree text: Achy, fatigue, no cold or feverMedDRA releases: 2024-11 · check-in free text available
- 2021-11-28
- 2021-12-05
- 2021-12-12
- 2022-01-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-17 | Moderna | |
| 3 | 2021-10-31 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Same four hives I get after the flu shot every year likely attributed to the adjuvant.
Systemic reaction (other): Four hives same as those I get after annual flu shot. Assume its a mild allergic reaction to the adjuvant.
Systemic reaction (other): Fading hives under arms I always get after flu shot as well. Probably mild allergy to component of adjuvant. Maybe a preservative (formaldehyde releaser?)
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): 4 large hives which I always get after any vaccine. Excipients?
Systemic reaction (other): Four hives that I always get after every vaccine. Probably excipient related.
Systemic reaction (other): Fading hives.
Release 10 — day 21, dose 3
Symptoms: Achy, fatigue, no cold or fever
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Fatigue | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | ✓ | ✓ | ✓ |
| SRO | Urticaria | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release