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4CW-43643-49310

3 vaccinations 6 coded responses 10 check-ins 6 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
940 / CA
Registered
2021-12-20
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-07
    Dose 1 — Moderna
  2. 2021-03-09
    Dose 2 — Moderna
  3. 2021-12-20
    Registered in v-safe
  4. 2021-12-20
    Dose 3 — Moderna
  5. 2021-12-20
    Health check-in — day 0, dose 3
    Feeling: Good · None
    Adult check-in
  6. 2021-12-21
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  7. 2021-12-22
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Pain in right armpit
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-12-23
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain, Feeling of body temperature change, Oedema peripheral — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: I am running hot and cold and i still have a painful swelling in the armpit of the arm receiving the vaccx.
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-12-24
    Survey response — days 1–6 daily, dose 3
    MedDRA: Feeling of body temperature change — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: I still continue to run hot and cold
    MedDRA releases: 2024-11 · check-in free text available
  10. 2021-12-25
    Survey response — days 1–6 daily, dose 3
    MedDRA: Feeling of body temperature change, Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Still running hot and cold. Armpit gland still painfully swollen.
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-12-26
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymph node pain, Unevaluable event — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness
    Free text: Still seating alot and gland in my armpit remains tender
    MedDRA releases: 2024-11 · check-in free text available
  12. 2022-01-01
    Health check-in — day 7, dose 3
    Feeling: Good · Site: Pain, Redness · Fatigue or tiredness
    Adult check-in
  13. 2022-01-05
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  14. 2022-01-11
    Survey response — day 21, dose 3
    MedDRA: Rash — Feeling: Good
    Free text: I just noticed a slight rash on the left side of my left breast. I received the booster shot in my left arm, so i suspect that they are related. It's not painful, so there was nothing to draw my attention to it.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-02-07Moderna No
22021-03-09Moderna No
32021-12-20Moderna No

Free text

Release 10 — days 1–6 daily, dose 3

2021-12-22

Systemic reaction (other): Pain in right armpit

2021-12-23

Systemic reaction (other): I am running hot and cold and i still have a painful swelling in the armpit of the arm receiving the vaccx.

2021-12-24

Systemic reaction (other): I still continue to run hot and cold

2021-12-25

Systemic reaction (other): Still running hot and cold. Armpit gland still painfully swollen.

2021-12-26

Systemic reaction (other): Still seating alot and gland in my armpit remains tender

Release 10 — day 21, dose 3

2022-01-11

Symptoms: I just noticed a slight rash on the left side of my left breast. I received the booster shot in my left arm, so i suspect that they are related. It's not painful, so there was nothing to draw my attention to it.

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
SDRash · · ✓
SROAxillary pain · · ✓
SROFeeling of body temperature change · · ✓
SROLymph node pain · · ✓
SROLymphadenopathy · · ✓
SROOedema peripheral · · ✓
SROUnevaluable event · · ✓

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