4AF-22692-43738
1 vaccination
4 coded responses
7 check-ins
4 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 770 / TX
- Registered
- 2021-01-24
- Relationship
- Self
Timeline
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2021-01-20
Dose 1 — Moderna
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2021-01-24
Registered in v-safe
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2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Office visit, SARS-CoV-2 test negative — Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Allergist examination and tested negative for COVID-19 at urgent careMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-24
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Urticaria — Feeling: Fair · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site · Be unable to work, 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: Hives all over body (none local) spread entire body today. Went to (b)(6) and got Dexamethasone steroid intramuscular shot in the left gluteus maximusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-25
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-26
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness, Swelling, Itching · None · Be unable to do your normal daily activitiesAdult check-in
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2021-01-27
Survey response — day 7, dose 1MedDRA: Emergency care, Medical observation, Rash — Feeling: Poor · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Systemic reaction (other): Severe rash all over body since Saturday. Extreme this morning had to go to ER · Healthcare visit (other): (b)(6)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-27
Report sent to call center — day 7, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-05
Survey response — day 14, dose 1MedDRA: Emergency care, Inflammation, Office visit, Pyrexia, Urticaria — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Delayed reaction within 48 hours of first dose. Breakout in hives all over body. Entire body was inflammed. Low grade fever. Hives lasted for days. Went to Urgent care, then R, then (b)(6) Hospital for treatment.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-05
Report sent to call center — day 14, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-12
- 2021-02-17
- 2021-06-03
- 2021-06-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna |
Call center
4 call center cases
4 unsuccessful
1 wait over 3 months for a first call
Free text
Release 2 — days 1–6 daily, dose 1
Healthcare visit (other): Allergist examination and tested negative for COVID-19 at urgent care
Systemic reaction (other): Hives all over body (none local) spread entire body today. Went to (b)(6) and got Dexamethasone steroid intramuscular shot in the left gluteus maximus
redacted (b)(6)
Release 2 — day 7, dose 1
Systemic reaction (other): Severe rash all over body since Saturday. Extreme this morning had to go to ER
Healthcare visit (other): (b)(6)
redacted (b)(6)
Release 3 — day 14, dose 1
Symptoms: Delayed reaction within 48 hours of first dose. Breakout in hives all over body. Entire body was inflammed. Low grade fever. Hives lasted for days. Went to Urgent care, then R, then (b)(6) Hospital for treatment.
redacted (b)(6)
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 |
|---|---|---|---|---|
| HCVO | Medical observation | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| HCVO | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Inflammation | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Emergency care | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release