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49P-14295-19721

4 vaccinations 4 coded responses 25 check-ins 4 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
970 / OR
Registered
2021-01-17
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-17
    Registered in v-safe
  2. 2021-01-17
    Dose 1 — Moderna
  3. 2021-01-17
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Swelling · Muscle or body aches
    Adult check-in
  4. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  5. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  6. 2021-01-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · Muscle or body aches
    Adult check-in
  7. 2021-01-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-24
    Survey response — day 7, dose 1
    MedDRA: Medical counselling, Photopsia, Visual field defect, Visual impairment, Vitreous disorder — Feeling: Good · Headache
    Free text: Yesterday right after I sent in the report I had a first time symptom with my eyes . My vision got weird and I was seeing triangular shapes and flashing lights in my perfrifel vision called eye doc and he said most likely a random symptom of vitreousis. Eyes seem fine today. Will get checked tomorrow. No headache. Or high blood pressure.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-01-31
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-07
    Survey response — day 21, dose 1
    MedDRA: Injection site reaction, Rash erythematous, Rash pruritic, Tenderness — Feeling: Good
    Free text: Large oblong red looking melted rash on and around upper arm injection site. Very itchy for two days with tenderness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-14
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-21
    Dose 2 — Moderna
  14. 2021-02-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-02-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: No
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Joint pains
    Adult check-in
  17. 2021-02-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-02-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-28
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-03-07
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-14
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-21
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-28
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-04
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-23
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-08-22
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2022-02-21
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2022-04-12
    Dose 3 — Moderna
  29. 2022-04-23
    Dose 4 — Moderna
  30. 2022-04-23
    Survey response — day 0, dose 4
    MedDRA: No adverse event — Feeling: Good
    Free text: None
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-17Moderna
22021-02-21Moderna
32022-04-12Moderna No
42022-04-23Moderna No

Free text

Release 2 — day 7, dose 1

2021-01-24

Systemic reaction (other): Yesterday right after I sent in the report I had a first time symptom with my eyes . My vision got weird and I was seeing triangular shapes and flashing lights in my perfrifel vision called eye doc and he said most likely a random symptom of vitreousis. Eyes seem fine today. Will get checked tomorrow. No headache. Or high blood pressure.

Release 3 — day 21, dose 1

2021-02-07

Symptoms: Large oblong red looking melted rash on and around upper arm injection site. Very itchy for two days with tenderness

Release 4 — days 1–6 daily, dose 2

2021-02-24

Systemic reaction (other): No

Release 11 — day 0, dose 4

2022-04-23

Systemic reaction (other): None

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
SDInjection site reaction ✓ ✓ ✓
SDRash erythematous ✓ ✓ ✓
SDRash pruritic ✓ ✓ ✓
SDTenderness ✓ ✓ ✓
SROMedical counselling ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓
SROPhotopsia ✓ ✓ ✓
SROVisual field defect ✓ ✓ ✓
SROVisual impairment ✓ ✓ ✓
SROVitreous disorder ✓ ✓ ✓

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