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3XY-39598-03137

2 vaccinations 5 coded responses 9 check-ins 5 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
956 / CA
Registered
2021-04-27
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-27
    Dose 1 — Moderna
  2. 2021-04-25
    Dose 2 — Moderna
  3. 2021-04-27
    Registered in v-safe
  4. 2021-04-27
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue, Pain, Pain in extremity, Pyrexia, Self-medication — Feeling: Good · Site: Pain, Swelling · Muscle or body aches
    Free text: I had mild fever, body aches, fatigue, severe pain in injection arm within 12 hours after the injection. Tylenol did not relieve any of the pain.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness
    Adult check-in
  6. 2021-04-29
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain, Swelling, Itching
    Free text: Sore throat on one part of the throat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-30
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site swelling, Lymphadenopathy, Oropharyngeal pain, Tonsillar hypertrophy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching
    Free text: Tonsils on left side of throat (injection side) very swollen and throat hurts only on left side, glands on left side of neck under chin very swollen, injection area still swollen and inches inside
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-05-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pain in extremity, Pruritus, Tonsillitis — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness
    Free text: Tonsillitis has progressed. Both sides of throat are red, swollen, and filled with pus. Injection arm is still swollen ans itchy.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-05-02
    Survey response — day 7, dose 2
    MedDRA: Increased viscosity of upper respiratory secretion, Injection site pruritus, Injection site swelling, Lymphadenopathy, Oropharyngeal pain, Pain in extremity, Pharyngeal swelling — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Free text: Some swelling in the injection arm but the pain and itching are mostly gone. Throat still hurts, swollen, and haa white pus and lymph nodes under chin still swollen.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-09
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-07-25
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-10-27
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-27Moderna
22021-04-25Moderna

Free text

Release 8 — days 1–6 daily, dose 2

2021-04-27

Systemic reaction (other): I had mild fever, body aches, fatigue, severe pain in injection arm within 12 hours after the injection. Tylenol did not relieve any of the pain.

2021-04-29

Systemic reaction (other): Sore throat on one part of the throat

2021-04-30

Systemic reaction (other): Tonsils on left side of throat (injection side) very swollen and throat hurts only on left side, glands on left side of neck under chin very swollen, injection area still swollen and inches inside

2021-05-01

Systemic reaction (other): Tonsillitis has progressed. Both sides of throat are red, swollen, and filled with pus. Injection arm is still swollen ans itchy.

Release 8 — day 7, dose 2

2021-05-02

Systemic reaction (other): Some swelling in the injection arm but the pain and itching are mostly gone. Throat still hurts, swollen, and haa white pus and lymph nodes under chin still swollen.

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

FieldPreferred term2021-092023-042024-11
SROFatigue ✓ ✓ ✓
SROIncreased viscosity of upper respiratory secretion ✓ ✓ ✓
SROInjection site pruritus ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPharyngeal swelling ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓
SROTonsillar hypertrophy ✓ ✓ ✓
SROTonsillitis ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release