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3J7-17859-17800

1 vaccination 2 coded responses 8 check-ins 2 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
136 / NY
Registered
2021-03-23
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-16
    Dose 1 — Moderna
  2. 2021-03-23
    Registered in v-safe
  3. 2021-03-23
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Redness, Swelling, Itching · None
    Adult check-in
  4. 2021-03-30
    Survey response — day 14, dose 1
    MedDRA: Burning sensation, Fatigue, Malaise, Oedema peripheral, Pain in extremity, Pruritus, Rash, Tenderness — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Rash on arm is finally gone, it took over my entire upper arm for a week with itching, swelling, burning, and couldnt touch it ,too painful. Felt terrible for the week and very tired. I am not getting the second one.informed my Doctor of this arm.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-06
    Survey response — day 21, dose 1
    MedDRA: Burning sensation, Injection site pain, Pain in extremity, Peripheral swelling, Pruritus, Rash, Swelling, Temperature intolerance — Feeling: Fair
    Free text: Arm sensitive to heat then itch starts. Its been 3 weeks since i got the first vaccine and i won't be getting the second dose, refuse to go through this swelling, pain, burning, itch and rash covering around my entire upper arm again.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-22
    Health check-in — day 35, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-04-27
    Health check-in — day 42, dose 1
    Feeling: Good
    Adult check-in
  8. 2021-06-15
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-09-16
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  10. 2022-03-16
    Health check-in — 12 months, dose 1
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-16Moderna

Free text

Release 6 — day 14, dose 1

2021-03-30

Symptoms: Rash on arm is finally gone, it took over my entire upper arm for a week with itching, swelling, burning, and couldnt touch it ,too painful. Felt terrible for the week and very tired. I am not getting the second one.informed my Doctor of this arm. cut off by CDC

Release 7 — day 21, dose 1

2021-04-06

Symptoms: Arm sensitive to heat then itch starts. Its been 3 weeks since i got the first vaccine and i won't be getting the second dose, refuse to go through this swelling, pain, burning, itch and rash covering around my entire upper arm again.

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
SDBurning sensation ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDInjection site pain ○ ✓ ○
SDMalaise ✓ ✓ ✓
SDOedema peripheral ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDPeripheral swelling ✓ · ✓
SDPruritus ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDSwelling ○ ✓ ○
SDTemperature intolerance ✓ · ✓
SDTenderness ✓ ✓ ✓

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