47X-36095-13308
4 vaccinations
6 coded responses
24 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 672 / KS
- Registered
- 2021-01-02
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-01-02
Registered in v-safe
-
2021-01-02
Dose 1 — Moderna
- 2021-01-02
-
2021-01-03
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
-
2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Pruritus — Feeling: Good · Site: Pain, Redness, ItchingFree text: Itching was more of a symptom yesterday than today. Today - the injection site is tender with pressure it I'm not feeling it with use of the arm. I marked mild because the symptoms are present but they are less than yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-05
- 2021-01-06
-
2021-01-07
Survey response — days 1–6 daily, dose 1MedDRA: Pain in jaw, Swelling face, Tenderness — Feeling: GoodFree text: Localized swollen area under right jaw - very tender to touch and a pressure type of pain when I bend over at that spotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-08
Survey response — days 1–6 daily, dose 1MedDRA: Pain in jaw, Swelling face — Feeling: GoodFree text: Left jaw continues to be a little swollen and tender - lessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-09
Survey response — day 7, dose 1MedDRA: Lymph node pain, Lymphadenopathy — Feeling: GoodFree text: Minimal tenderness over node in neck, minimal swellingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-16
- 2021-01-23
-
2021-01-30
Dose 2 — Moderna
- 2021-04-03
- 2021-07-03
-
2021-11-19
Dose 3 — ModernaCo-administered: Flu
- 2022-01-02
-
2022-09-23
Dose 4 — Moderna
- 2022-09-27
- 2022-09-28
- 2022-09-29
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-11-06
-
2022-12-23
Survey response — 3 months, dose 4MedDRA: Hysterectomy — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I had a hysterectomy yesterday. No complications. Pacing myself for recoveryMedDRA releases: 2024-11 · check-in free text available
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2022-12-23
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-27
-
2023-01-03
Call successfulNot applicable - Accidental Reporting
-
2023-03-24
Survey response — 6 months, dose 4MedDRA: Hysterectomy — Feeling: Good · Be unable to work or attend schoolMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-02 | Moderna | |
| 2 | 2021-01-30 | Moderna | No |
| 3 | 2021-11-19 | Moderna | Flu |
| 4 | 2022-09-23 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Itching was more of a symptom yesterday than today. Today - the injection site is tender with pressure it I'm not feeling it with use of the arm. I marked mild because the symptoms are present but they are less than yesterday
Systemic reaction (other): Localized swollen area under right jaw - very tender to touch and a pressure type of pain when I bend over at that spot
Systemic reaction (other): Left jaw continues to be a little swollen and tender - less
Release 1 — day 7, dose 1
Systemic reaction (other): Minimal tenderness over node in neck, minimal swelling
Release 12 — 3 months, dose 4
Symptoms: I had a hysterectomy yesterday. No complications. Pacing myself for recovery
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 | Hysterectomy | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ○ | ○ | ○ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Swelling face | ✓ | ✓ | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release