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
-
2021-02-07
Dose 1 — Moderna
-
2021-03-09
Dose 2 — Moderna
-
2021-12-20
Registered in v-safe
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2021-12-20
Dose 3 — Moderna
- 2021-12-20
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2021-12-21
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-12-22
Survey response — days 1–6 daily, dose 3MedDRA: 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 activitiesFree text: Pain in right armpitMedDRA releases: 2024-11 · check-in free text available
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2021-12-23
Survey response — days 1–6 daily, dose 3MedDRA: 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 activitiesFree 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
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2021-12-24
Survey response — days 1–6 daily, dose 3MedDRA: Feeling of body temperature change — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: I still continue to run hot and coldMedDRA releases: 2024-11 · check-in free text available
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2021-12-25
Survey response — days 1–6 daily, dose 3MedDRA: Feeling of body temperature change, Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Still running hot and cold. Armpit gland still painfully swollen.MedDRA releases: 2024-11 · check-in free text available
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2021-12-26
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain, Unevaluable event — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tirednessFree text: Still seating alot and gland in my armpit remains tenderMedDRA releases: 2024-11 · check-in free text available
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2022-01-01
Health check-in — day 7, dose 3Feeling: Good · Site: Pain, Redness · Fatigue or tirednessAdult check-in
- 2022-01-05
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2022-01-11
Survey response — day 21, dose 3MedDRA: Rash — Feeling: GoodFree 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
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-07 | Moderna | No |
| 2 | 2021-03-09 | Moderna | No |
| 3 | 2021-12-20 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Pain in right armpit
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.
Systemic reaction (other): I still continue to run hot and cold
Systemic reaction (other): Still running hot and cold. Armpit gland still painfully swollen.
Systemic reaction (other): Still seating alot and gland in my armpit remains tender
Release 10 — day 21, dose 3
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Rash | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Feeling of body temperature change | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release