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4NB-25346-20342

3 vaccinations 7 coded responses 24 check-ins 7 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
921 / CA
Registered
2021-02-04
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-02
    Dose 1 — Moderna
  2. 2021-02-04
    Registered in v-safe
  3. 2021-02-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site pain — Feeling: Good
    Free text: Soreness at injection site 2days only
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-02-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site pain — Feeling: Good
    Free text: Soreness at injection site 2 days only
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-08
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site pain — Feeling: Good
    Free text: Soreness at injection site 2days only
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-18
    Survey response — day 14, dose 1
    MedDRA: Injection site pruritus, Injection site rash, Therapeutic response unexpected — Feeling: Good
    Free text: Itching at injection site then a 2inch oval rash just below injection site on 2/13/21. Applied ice pack..itching stopped and rash barely visible next day 2/14/21.then gone 2/15/21! I have psoriactic arthritis. Feel great since then. Thank you!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-24
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-03-02
    Dose 2 — Moderna
  10. 2021-03-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Chills, Fatigue or tiredness
    Adult check-in
  11. 2021-03-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Decreased appetite, Fatigue — Feeling: Good
    Free text: Yesterday March 4- slight loss of appetite + tremendous fatigue and was in bed from 1:15p-6:30a..17hrs
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Ear discomfort, Influenza like illness, Nasal congestion, Upper-airway cough syndrome — Feeling: Good
    Free text: 3-4 Right ear blocked a few hours, then a little nasal congestion and drip...flu-like..then gone by bedtime. Thank you
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-09
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-03-16
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-03-24
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-03-31
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-04-06
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-04-14
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-06-01
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-08-31
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-10-03
    Dose 3 — Moderna
    Co-administered: Flu
  22. 2021-10-26
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  23. 2021-10-31
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  24. 2021-11-08
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  25. 2021-11-14
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  26. 2022-01-02
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  27. 2022-04-04
    Survey response — 6 months, dose 3
    MedDRA: Injection site pain — Feeling: Good
    Free text: Every now and then a soreness at the injection site that lasts for a minute or two.
    MedDRA releases: 2024-11 · check-in free text available
  28. 2022-10-03
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-02Moderna
22021-03-02Moderna
32021-10-03Moderna Flu

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Soreness at injection site 2days only

2021-02-07

Systemic reaction (other): Soreness at injection site 2 days only

2021-02-08

Systemic reaction (other): Soreness at injection site 2days only

Release 4 — day 14, dose 1

2021-02-18

Symptoms: Itching at injection site then a 2inch oval rash just below injection site on 2/13/21. Applied ice pack..itching stopped and rash barely visible next day 2/14/21.then gone 2/15/21! I have psoriactic arthritis. Feel great since then. Thank you!

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Yesterday March 4- slight loss of appetite + tremendous fatigue and was in bed from 1:15p-6:30a..17hrs

2021-03-05

Systemic reaction (other): 3-4 Right ear blocked a few hours, then a little nasal congestion and drip...flu-like..then gone by bedtime. Thank you

Release 11 — 6 months, dose 3

2022-04-04

Symptoms: Every now and then a soreness at the injection site that lasts for a minute or two.

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
SDInjection site pain · · ✓
SDInjection site pruritus ✓ ✓ ✓
SDInjection site rash ✓ ✓ ✓
SDTherapeutic response unexpected ✓ ✓ ✓
SRODecreased appetite ✓ ✓ ✓
SROEar discomfort ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROInfluenza like illness ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SRONasal congestion ✓ ✓ ✓
SROUpper-airway cough syndrome ✓ ✓ ✓

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