4M3-11092-38508
5 vaccinations
3 coded responses
34 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 200 / DC
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Dose 1 — Moderna
-
2021-02-03
Registered in v-safe
- 2021-02-03
-
2021-02-10
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pruritus, Injection site rash, Injection site reaction, Lymphadenopathy, Pruritus, Rash erythematous — Feeling: GoodFree text: Itchy vaccination site and small circular red rash 7 days after Moderna first shot. That resoved in a few days. Then swollen lymph node snd some itch in left underarm. That is almost completely gone.I am and have been feeling goodMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
- 2021-02-25
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-05-26
-
2021-08-25
Survey response — 6 months, dose 2MedDRA: Ear discomfort, Nasal congestion, SARS-CoV-2 test negative, Vertigo, Vertigo positional — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Vertigo, stuffiness ears and nose.Negative results on covid test 8/20/21 · Healthcare visit (other): This was just for first instance of positional vertigoMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-25
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-01
-
2021-11-05
Dose 3 — Moderna
-
2022-02-26
Survey response — 12 months, dose 2MedDRA: Aneurysm, Hospitalisation — Feeling: Good · Be unable to work or attend schoolFree text: Yes. A non-covid related aneurysm, for which I was hospitalized for microsurgery to have it clippedMedDRA releases: 2024-11 · check-in free text available
-
2022-04-12
Dose 4 — Moderna
-
2022-09-21
Dose 5 — Moderna
- 2022-09-21
- 2022-09-22
- 2022-09-23
- 2022-09-24
- 2022-09-25
- 2022-09-26
- 2022-09-27
- 2022-09-28
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-12-22
- 2023-03-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
| 5 | 2022-09-21 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 4 — day 14, dose 1
Symptoms: Itchy vaccination site and small circular red rash 7 days after Moderna first shot. That resoved in a few days. Then swollen lymph node snd some itch in left underarm. That is almost completely gone.I am and have been feeling good
Release 9 — 6 months, dose 2
Symptoms: Vertigo, stuffiness ears and nose.Negative results on covid test 8/20/21
Healthcare visit (other): This was just for first instance of positional vertigo
Release 11 — 12 months, dose 2
Symptoms: Yes. A non-covid related aneurysm, for which I was hospitalized for microsurgery to have it clipped
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 | Vertigo positional | ✓ | · | ✓ |
| SD | Aneurysm | · | · | ✓ |
| SD | Ear discomfort | ✓ | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ○ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ○ |
| SD | Injection site reaction | · | · | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash erythematous | · | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | · | ✓ |
| SD | Vertigo | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release