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4HV-59288-53186

2 vaccinations 2 coded responses 8 check-ins 2 free-text entries 0 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
630 / MO
Registered
2021-02-02
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-02
    Registered in v-safe
  2. 2021-02-09
    Dose 1 — Moderna
  3. 2021-02-25
    Survey response — day 14, dose 1
    MedDRA: Erythema, Injection site erythema, Injection site pruritus, Pain in extremity, Pruritus, Sensory disturbance — Feeling: Good
    Free text: After 1st Moderna shot, no reaction other than slightly sore arm. Approx 20 Feb, noticed a slight sensation on arm with slight itching and reddening starting at shot site and down my arm into bicep( spot about 4 in wide by 6 in long. Has persisted
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-02
    Survey response — day 21, dose 1
    MedDRA: Injection site pain, Injection site reaction — Feeling: Good
    Free text: About 1 week after shot I had a 4 x 6 red blotch from shot location down into my bicep/ slightly sore but has since almost disappeared: seems to be going away!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-09
    Dose 2 — Moderna
  6. 2021-03-16
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  7. 2021-03-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  8. 2021-03-30
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-04-06
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-04-15
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-04-20
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-09Moderna
22021-03-09Moderna

Free text

Release 4 — day 14, dose 1

2021-02-25

Symptoms: After 1st Moderna shot, no reaction other than slightly sore arm. Approx 20 Feb, noticed a slight sensation on arm with slight itching and reddening starting at shot site and down my arm into bicep( spot about 4 in wide by 6 in long. Has persisted cut off by CDC

Release 4 — day 21, dose 1

2021-03-02

Symptoms: About 1 week after shot I had a 4 x 6 red blotch from shot location down into my bicep/ slightly sore but has since almost disappeared: seems to be going away!

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
SDErythema ✓ ✓ ✓
SDInjection site erythema ✓ · ✓
SDInjection site pain ✓ ✓ ✓
SDInjection site pruritus ✓ · ✓
SDInjection site reaction ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDSensory disturbance ✓ · ✓

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