3KX-18153-86582
3 vaccinations
5 coded responses
39 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 31-35
- ZIP prefix
- 900 / CA
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-19
Registered in v-safe
-
2021-03-19
Dose 1 — Moderna
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-04-02
- 2021-04-09
-
2021-04-16
Dose 2 — Moderna
- 2021-04-16
-
2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-19
- 2021-04-20
- 2021-04-22
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-23
- 2021-05-28
- 2021-07-16
- 2021-10-17
-
2021-11-03
Dose 3 — Moderna
- 2021-11-03
- 2021-11-04
-
2021-11-05
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Pain, Swelling · Joint painsFree text: Swollen, painful armpit on same arm as injectionMedDRA releases: 2024-11 · check-in free text available
-
2021-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: PainFree text: Swelling and soreness of armpit on the same side as the injection for second day.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: GoodFree text: Swelling & soreness in armpit on the same side as injection for third day (began 48 hrs post-shot, improving now)MedDRA releases: 2024-11 · check-in free text available
-
2021-11-08
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: GoodFree text: Swelling & soreness in armpit on the same side as injection. (day 4 of this symptom, improving even more than yesterday)MedDRA releases: 2024-11 · check-in free text available
-
2021-11-09
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: GoodFree text: Swelling & soreness of armpit on same side as injection has almost fully gone away.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-11
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2022-02-02
- 2022-05-04
- 2022-11-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-19 | Moderna | |
| 2 | 2021-04-16 | Moderna | |
| 3 | 2021-11-03 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Swollen, painful armpit on same arm as injection
Systemic reaction (other): Swelling and soreness of armpit on the same side as the injection for second day.
Systemic reaction (other): Swelling & soreness in armpit on the same side as injection for third day (began 48 hrs post-shot, improving now)
Systemic reaction (other): Swelling & soreness in armpit on the same side as injection. (day 4 of this symptom, improving even more than yesterday)
Systemic reaction (other): Swelling & soreness of armpit on same side as injection has almost fully gone away.
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 |
|---|---|---|---|---|
| SRO | Axillary pain | · | · | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release