3Q6-12139-32598
1 vaccination
2 coded responses
8 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 335 / FL
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Dose 1 — Moderna
-
2021-03-05
Registered in v-safe
-
2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Eye pruritus, Hypoaesthesia oral, Lip swelling — Feeling: GoodFree text: I got the shot 3/3 at 5:45 PM. Around 9:15 PM that evening, my eyes began itching and lasted 45- 60 minutes then stopped. I went to bed around 1:00 AM and my upper lip felt slightly swollen and numbing, but not severe. This lasted 45-60 minutes then went away. Since then I have felt fine. I need to be notified if I should still receive my 2nd shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Hypersensitivity — Feeling: GoodFree text: After experiencing slight allergy issues the day of the injection, I want to be notified whether or not I should receive the 2nd injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-17
- 2021-03-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): I got the shot 3/3 at 5:45 PM. Around 9:15 PM that evening, my eyes began itching and lasted 45- 60 minutes then stopped. I went to bed around 1:00 AM and my upper lip felt slightly swollen and numbing, but not severe. This lasted 45-60 minutes then went away. Since then I have felt fine. I need to be notified if I should still receive my 2nd shot.
Systemic reaction (other): After experiencing slight allergy issues the day of the injection, I want to be notified whether or not I should receive the 2nd injection.
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 | Eye pruritus | ✓ | ✓ | ✓ |
| SRO | Hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia oral | ✓ | ✓ | ✓ |
| SRO | Lip swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release