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33S-94302-70624

1 vaccination 1 coded response 5 check-ins 1 free-text entry 0 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
384 / TN
Registered
2021-02-27
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-27
    Registered in v-safe
  2. 2021-02-27
    Dose 1 — Moderna
  3. 2021-02-27
    Survey response — day 0, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Chills
    Free text: During my vaccination the Tech failed to administer the shot correctly. Once he put the needle in my arm the fluid spilled on my arm and clothes. He assured me that it was normal to have spillage. However, I ask to speak to the person in charge. She stated unfortunately there was nothing they could do and hoped that some of the vaccine entered my arm. Im very disappointed how dismissive they were regarding my concern. Again, I felt the needle penetrate my arm, but the fluid ran down my arm/clothing instead. I was looking forward to finally getting the vaccine and now Im left with concern.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-20
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  5. 2021-03-27
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-04-03
    Health check-in — day 35, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-08-28
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-27Moderna

Free text

Release 4 — day 0, dose 1

2021-02-27

Systemic reaction (other): During my vaccination the Tech failed to administer the shot correctly. Once he put the needle in my arm the fluid spilled on my arm and clothes. He assured me that it was normal to have spillage. However, I ask to speak to the person in charge. She stated unfortunately there was nothing they could do and hoped that some of the vaccine entered my arm. Im very disappointed how dismissive they were regarding my concern. Again, I felt the needle penetrate my arm, but the fluid ran down my arm/clothing instead. I was looking forward to finally getting the vaccine and now Im left with concern.

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

FieldPreferred term2021-092023-042024-11
SROUnevaluable event ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release