3UE-36999-33069
2 vaccinations
4 coded responses
23 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 201 / VA
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
-
2020-12-28
Health check-in — day 0, dose 1Feeling: Good · Site: Pain · Fever · Headache, Muscle or body achesAdult check-in
-
2020-12-29
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2020-12-30
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2020-12-31
- 2021-01-02
- 2021-01-04
- 2021-01-11
- 2021-01-19
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
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2021-01-26
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: dizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-08
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2021-02-15
Survey response — day 21, dose 2MedDRA: Lymphadenopathy, Urticaria — Feeling: GoodFree text: I have had 6 hive like lesions appear on my body. Also, I have a payable Asymmetric right occipital lymph node seen measuring 9 x 8 mm on the right side. There is no elevated white blood count. I did get my vaccine on the right side.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-22
-
2021-03-01
Survey response — day 35, dose 2MedDRA: Infection, Lymphadenopathy, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Another rash on my chest on the right side. Also, I have some kind if infection and needed to be on antibiotics. This occurred after 2nd shot, about 3 to weeks later. The enlarged lymph in neck is decreasing after antibiotics.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-08
Survey response — day 42, dose 2MedDRA: Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Rash on right chest area.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-26
- 2021-07-26
-
2021-09-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): dizziness
Release 4 — day 21, dose 2
Symptoms: I have had 6 hive like lesions appear on my body. Also, I have a payable Asymmetric right occipital lymph node seen measuring 9 x 8 mm on the right side. There is no elevated white blood count. I did get my vaccine on the right side.
Release 4 — day 35, dose 2
Symptoms: Another rash on my chest on the right side. Also, I have some kind if infection and needed to be on antibiotics. This occurred after 2nd shot, about 3 to weeks later. The enlarged lymph in neck is decreasing after antibiotics.
Release 5 — day 42, dose 2
Symptoms: Rash on right chest area.
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 | Infection | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release