3UB-26431-88746
4 vaccinations
4 coded responses
41 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 201 / VA
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Dose 1 — Moderna
-
2021-03-18
Registered in v-safe
- 2021-03-18
- 2021-03-19
- 2021-03-20
-
2021-03-21
Survey response — days 1–6 daily, dose 1MedDRA: Rhinorrhoea — Feeling: GoodFree text: Not sure, since I generally experience a runny nose, but it does seem that my nose is running more than I consider normal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
- 2021-03-23
-
2021-03-30
Survey response — day 14, dose 1MedDRA: Rash, Rash pruritic, Self-medication — Feeling: GoodFree text: For about 4 or 5 days I experienced the most unbelievable itchy rash...mostly on my thigh but also on the lower leg, arms, and shoulders. I treated it with ice, Xrtek and Claritin. Seems to be much better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
-
2021-04-13
Dose 2 — Moderna
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
-
2021-07-13
Survey response — 3 months, dose 2MedDRA: Office visit, Pain in extremity, Peripheral swelling — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Unexplained swollen and painful left foot. Lasted about a week. · Healthcare visit (other): PodiatristMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-13
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-22
- 2021-10-14
-
2021-10-27
Dose 3 — Moderna
- 2021-10-30
- 2021-10-31
- 2021-11-01
-
2021-11-03
Health check-in — day 7, dose 3Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-11-12
- 2021-11-19
- 2021-11-24
- 2021-12-01
- 2021-12-09
- 2022-01-27
-
2022-04-01
Dose 4 — Pfizer-BioNTech
-
2022-04-19
Survey response — day 14, dose 4MedDRA: Rhinorrhoea — Feeling: GoodFree text: My nose seems to be running more than usual although this may as likely be attributed to the change of season,MedDRA releases: 2024-11 · check-in free text available
- 2022-04-22
- 2022-04-29
- 2022-05-08
- 2022-05-13
- 2022-07-01
- 2022-09-30
- 2023-04-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-13 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-01 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Not sure, since I generally experience a runny nose, but it does seem that my nose is running more than I consider normal.
Release 6 — day 14, dose 1
Symptoms: For about 4 or 5 days I experienced the most unbelievable itchy rash...mostly on my thigh but also on the lower leg, arms, and shoulders. I treated it with ice, Xrtek and Claritin. Seems to be much better today.
Release 9 — 3 months, dose 2
Symptoms: Unexplained swollen and painful left foot. Lasted about a week.
Healthcare visit (other): Podiatrist
Release 11 — day 14, dose 4
Symptoms: My nose seems to be running more than usual although this may as likely be attributed to the change of season,
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release