3X3-18643-78718
4 vaccinations
4 coded responses
42 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 627 / IL
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Moderna
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-26
-
2021-02-02
Survey response — day 21, dose 1MedDRA: Injection site erythema, Injection site pruritus, Injection site rash, Injection site warmth — Feeling: GoodFree text: About a week ago, I noticed a 4-5 inch bright red rash in the area of my vaccine. It felt warm to the touch and itched. It spread a little bit. Now it is faded for the most part. I dont seem to have any other symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-09
Survey response — day 28, dose 1MedDRA: Limb discomfort — Feeling: GoodFree text: Not sure that it is related to my first vaccine, but I have experienced some discomfort in my left arm and my right hand. I had the shot in my left arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-11
Dose 2 — Moderna
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-05-13
- 2021-08-12
-
2021-11-02
Dose 3 — Moderna
- 2022-02-11
-
2022-04-26
Dose 4 — Moderna
- 2022-04-26
-
2022-04-27
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Fatigue or tirednessAdult check-in
-
2022-04-28
Survey response — days 1–6 daily, dose 4MedDRA: Injection site pain — Feeling: GoodFree text: Just a slight tenderness in shot area.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-29
- 2022-04-30
- 2022-05-01
- 2022-05-02
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-07-26
- 2022-10-26
-
2023-04-28
Survey response — 12 months, dose 4MedDRA: Fatigue, Palpitations, Pre-existing disease — Feeling: FairMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-04-26 | Moderna | No |
Free text
Release 3 — day 21, dose 1
Symptoms: About a week ago, I noticed a 4-5 inch bright red rash in the area of my vaccine. It felt warm to the touch and itched. It spread a little bit. Now it is faded for the most part. I dont seem to have any other symptoms.
Release 3 — day 28, dose 1
Symptoms: Not sure that it is related to my first vaccine, but I have experienced some discomfort in my left arm and my right hand. I had the shot in my left arm.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Just a slight tenderness in shot 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 | Fatigue | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
| SD | Limb discomfort | ✓ | ✓ | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release