4FS-32388-24598
5 vaccinations
8 coded responses
33 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 079 / NJ
- Registered
- 2021-02-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Dose 1 — Moderna
-
2021-02-06
Registered in v-safe
-
2021-02-06
Survey response — day 7, dose 1MedDRA: Adverse reaction — Feeling: Fair · Site: Redness, Swelling, ItchingFree text: Got Covid arm on February 5, 2021MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-11
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site hypersensitivity — Feeling: FairFree text: I still have delayed cutaneous hypersensitivity around the injection site. It started on day 9 or 10 after the injection and is still here today on day 15. It is slightly less red and hopefully will disappear soon.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
-
2021-02-23
Dose 2 — Moderna
- 2021-02-23
-
2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain, Redness · Fatigue or tirednessFree text: Much better than yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema — Feeling: Fair · Site: Pain, Redness · Fatigue or tirednessFree text: Arm around injection red for many inchesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Itching · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Musculoskeletal discomfort — Feeling: Fair · Site: Redness · Rash, not including the immediate area around the injection siteFree text: Still a bit redness from shoulder to elbow but less than yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Erythema, Rash — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: Arm still a little red or pink with a bit of a rashMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-02
Survey response — day 7, dose 2MedDRA: Dizziness, Syncope — Feeling: Fair · Site: Redness, Itching · Rash, not including the immediate area around the injection siteFree text: Very faintMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-05-25
- 2021-08-26
-
2021-08-27
Dose 3 — Moderna
- 2021-11-26
- 2022-02-27
-
2022-05-18
Dose 4 — Moderna
- 2022-08-27
-
2022-11-15
Dose 5 — Moderna
- 2022-11-15
- 2022-11-17
- 2022-11-18
- 2022-11-19
- 2022-11-20
- 2022-11-21
- 2022-11-22
- 2022-11-29
- 2022-12-06
- 2022-12-13
- 2022-12-20
- 2022-12-27
-
2023-05-16
Survey response — 6 months, dose 5MedDRA: Office visit, Pemphigoid — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-05-16
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professional1 call case(s)
- 2023-05-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-23 | Moderna | |
| 3 | 2021-08-27 | Moderna | No |
| 4 | 2022-05-18 | Moderna | No |
| 5 | 2022-11-15 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 3 — day 7, dose 1
Systemic reaction (other): Got Covid arm on February 5, 2021
Release 4 — day 14, dose 1
Symptoms: I still have delayed cutaneous hypersensitivity around the injection site. It started on day 9 or 10 after the injection and is still here today on day 15. It is slightly less red and hopefully will disappear soon.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Much better than yesterday
Systemic reaction (other): Arm around injection red for many inches
Systemic reaction (other): Still a bit redness from shoulder to elbow but less than yesterday
Systemic reaction (other): Arm still a little red or pink with a bit of a rash
Release 4 — day 7, dose 2
Systemic reaction (other): Very faint
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 | Office visit | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site hypersensitivity | ✓ | ✓ | ✓ |
| SD | Pemphigoid | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Immunisation reaction | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal discomfort | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Syncope | ○ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release