3BB-10435-77301
2 vaccinations
3 coded responses
22 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 061 / CT
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-06
Dose 1 — Moderna
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2021-01-07
Registered in v-safe
- 2021-01-07
- 2021-01-08
- 2021-01-09
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2021-01-13
Survey response — day 7, dose 1MedDRA: Pain, Tenderness — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I have tenderness in my left arm pit area I received my injection last week and my left arm. My doctor does not feel any swollen lymph nodes but she documented it as a possible reaction pain is not severe.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-13
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-21
Survey response — day 14, dose 1MedDRA: Peripheral swelling, Sciatica — Feeling: Good · Be unable to do your normal daily activitiesFree text: The swelling in my arm subsided by last Friday. However I woke up with terrible sciatica pain in my left hip/lower back on Thursday of last week. Not sure if its related to the lymphonapathy but it was on my left side where I got the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-27
Survey response — day 21, dose 1MedDRA: Fatigue — Feeling: FairFree text: Fatigue since MondayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-03
Dose 2 — Moderna
- 2021-02-03
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2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-04
- 2021-03-10
- 2021-03-17
- 2021-05-05
- 2021-08-05
- 2022-02-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 1 — day 7, dose 1
Systemic reaction (other): I have tenderness in my left arm pit area I received my injection last week and my left arm. My doctor does not feel any swollen lymph nodes but she documented it as a possible reaction pain is not severe.
Release 2 — day 14, dose 1
Symptoms: The swelling in my arm subsided by last Friday. However I woke up with terrible sciatica pain in my left hip/lower back on Thursday of last week. Not sure if its related to the lymphonapathy but it was on my left side where I got the vaccine
Release 2 — day 21, dose 1
Symptoms: Fatigue since Monday
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 | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Sciatica | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release