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45J-15071-26837

2 vaccinations 3 coded responses 10 check-ins 3 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
371 / TN
Registered
2021-04-10
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-25
    Dose 1 — Moderna
  2. 2021-04-10
    Registered in v-safe
  3. 2021-04-10
    Survey response — day 14, dose 1
    MedDRA: Arthralgia, Immediate post-injection reaction, Neuralgia, Obstructive airways disorder, Pain in extremity, Self-medication — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Airway started tightening approximately 30 minutes after vaccination. Felt relief within approximately ten minutes. The same night, the bottom of both feet became nerve sensitive with pain. Same pain was in the left foot up to the left hip. Ibuprofen
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-16
    Survey response — day 21, dose 1
    MedDRA: Arthralgia, Self-medication, Tenderness — Feeling: Fair
    Free text: My left ankle pain has not stopped. I have continued to take ibuprofen for the pain and tenderness. It hurts to put a sock on. All other pains have subsided. My ankle is not swollen, not red or hot, just tender to touch.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-22
    Dose 2 — Moderna
  6. 2021-04-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site erythema, Injection site reaction, Urticaria — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities
    Free text: Large red welp 5-6 inches below the injection site.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · None
    Adult check-in
  8. 2021-04-29
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-05-13
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-05-27
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-06-05
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-07-24
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-10-21
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-25Moderna
22021-04-22Moderna

Free text

Release 7 — day 14, dose 1

2021-04-10

Symptoms: Airway started tightening approximately 30 minutes after vaccination. Felt relief within approximately ten minutes. The same night, the bottom of both feet became nerve sensitive with pain. Same pain was in the left foot up to the left hip. Ibuprofen cut off by CDC

Release 7 — day 21, dose 1

2021-04-16

Symptoms: My left ankle pain has not stopped. I have continued to take ibuprofen for the pain and tenderness. It hurts to put a sock on. All other pains have subsided. My ankle is not swollen, not red or hot, just tender to touch.

Release 7 — days 1–6 daily, dose 2

2021-04-25

Systemic reaction (other): Large red welp 5-6 inches below the injection site.

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
SDArthralgia ✓ ✓ ✓
SDImmediate post-injection reaction ✓ ✓ ✓
SDNeuralgia ✓ ✓ ✓
SDObstructive airways disorder ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDSelf-medication ✓ ✓ ✓
SDTenderness ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site reaction ✓ ✓ ✓
SROUrticaria ✓ ✓ ✓

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