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
-
2021-02-02
Registered in v-safe
-
2021-02-09
Dose 1 — Moderna
-
2021-02-25
Survey response — day 14, dose 1MedDRA: Erythema, Injection site erythema, Injection site pruritus, Pain in extremity, Pruritus, Sensory disturbance — Feeling: GoodFree 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 persistedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-02
Survey response — day 21, dose 1MedDRA: Injection site pain, Injection site reaction — Feeling: GoodFree 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
-
2021-03-09
Dose 2 — Moderna
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-15
- 2021-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-09 | Moderna | |
| 2 | 2021-03-09 | Moderna |
Free text
Release 4 — day 14, dose 1
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | · | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | · | ✓ |
| SD | Injection site reaction | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Sensory disturbance | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release