4GN-19840-68894
5 vaccinations
3 coded responses
63 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 238 / VA
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
-
2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: Injection site discomfort, Injection site erythema — Feeling: GoodFree text: None. Slight, slight redness at injection site. On a scale of 1 to 10 where 10 is the worse, I give it a 1. If I touch the injection site, I feel it; but, absolutely NO pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-02-04
- 2021-02-11
- 2021-02-18
-
2021-02-22
Dose 2 — Moderna
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-05-24
- 2021-08-23
-
2021-11-02
Dose 3 — Moderna
- 2021-11-02
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-11-04
Survey response — days 1–6 daily, dose 3MedDRA: Injection site erythema, Injection site pain, Injection site swelling, Reaction to previous exposure to any vaccine — Feeling: Fair · Site: Pain, Redness, SwellingFree text: I have a red "strawberry" like swelling at the injection sight that is sensitive to the touch. Didn't experience this with first two Moderna vaccine shots. I have experienced similar reactions with vaccines in years past.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-11-07
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Swelling · NoneAdult check-in
- 2021-11-08
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-14
- 2022-02-01
-
2022-05-17
Dose 4 — Moderna
- 2022-05-17
- 2022-05-18
- 2022-05-19
- 2022-05-20
- 2022-05-21
- 2022-05-22
- 2022-05-23
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-06-14
- 2022-06-21
- 2022-06-28
- 2022-08-16
-
2022-10-10
Dose 5 — ModernaCo-administered: Flu
- 2022-10-10
- 2022-10-11
- 2022-10-12
- 2022-10-13
- 2022-10-14
- 2022-10-15
- 2022-10-16
- 2022-10-17
- 2022-10-24
- 2022-11-02
- 2022-11-07
- 2022-11-14
-
2022-11-21
Survey response — day 42, dose 5MedDRA: Influenza virus test negative, Malaise, SARS-CoV-2 test negative, Sinusitis — Feeling: Poor · 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: Prescribed Amoxicillin and Clavulanate Potassium Tablets, USP 875 mg/125 mg on Thursday November 17th for sinus infection. So far, very little relief from symptoms. Feeling lousy. Tests for COVID and flu were negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-21
Report sent to call center — day 42, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-01-09
- 2023-04-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-22 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-05-17 | Moderna | No |
| 5 | 2022-10-10 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): None. Slight, slight redness at injection site. On a scale of 1 to 10 where 10 is the worse, I give it a 1. If I touch the injection site, I feel it; but, absolutely NO pain.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I have a red "strawberry" like swelling at the injection sight that is sensitive to the touch. Didn't experience this with first two Moderna vaccine shots. I have experienced similar reactions with vaccines in years past.
Release 12 — day 42, dose 5
Symptoms: Prescribed Amoxicillin and Clavulanate Potassium Tablets, USP 875 mg/125 mg on Thursday November 17th for sinus infection. So far, very little relief from symptoms. Feeling lousy. Tests for COVID and flu were negative.
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 | Influenza virus test negative | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Injection site discomfort | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Injection site swelling | · | · | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release