4FK-18111-83812
2 vaccinations
4 coded responses
25 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 911 / CA
- Registered
- 2020-12-22
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-22
Registered in v-safe
-
2020-12-22
Dose 1 — Moderna
- 2020-12-22
-
2020-12-23
Survey response — days 1–6 daily, dose 1MedDRA: Musculoskeletal stiffness — Feeling: Good · Site: Pain, Swelling · FeverFree text: Back felt a little stiff this morning but resolved quickly and not sure if related to vaccinationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-26
- 2020-12-27
- 2020-12-28
- 2020-12-29
-
2021-01-06
Survey response — day 14, dose 1MedDRA: Injection site rash, Injection site reaction, Pruritus, Skin lesion — Feeling: GoodFree text: 10 pm on 6th day post vaccination (12/29) noticed raised, pink, mildly itchy skin lesions next to injection site. Next day these coalesced into a single, very large, pink, warm, mildly itchy lesion over upper arm. Delayed injection site reaction.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-12
- 2021-01-19
-
2021-01-20
Dose 2 — Moderna
-
2021-01-20
Survey response — day 0, dose 2MedDRA: Paraesthesia — Feeling: Good · Site: Pain · Muscle or body achesFree text: Mild tingling in injected arm down to fingersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-21
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · HeadacheAdult check-in
-
2021-01-23
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Migraine — Feeling: Good · Site: Swelling · HeadacheFree text: Took medicine for migraine headache so remained mild onlyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-02-03
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-04-21
- 2021-07-23
- 2022-01-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-22 | Moderna | |
| 2 | 2021-01-20 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Back felt a little stiff this morning but resolved quickly and not sure if related to vaccination
Release 1 — day 14, dose 1
Symptoms: 10 pm on 6th day post vaccination (12/29) noticed raised, pink, mildly itchy skin lesions next to injection site. Next day these coalesced into a single, very large, pink, warm, mildly itchy lesion over upper arm. Delayed injection site reaction.
Release 2 — day 0, dose 2
Systemic reaction (other): Mild tingling in injected arm down to fingers
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Took medicine for migraine headache so remained mild only
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 | Injection site rash | ✓ | ✓ | ✓ |
| SD | Injection site reaction | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Skin lesion | ✓ | ✓ | ✓ |
| SRO | Headache | ○ | ✓ | ○ |
| SRO | Migraine | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release