4QU-31218-65680
2 vaccinations
8 coded responses
21 check-ins
8 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 113 / NY
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-27
Registered in v-safe
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2021-02-27
Dose 1 — Moderna
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2021-02-27
Survey response — day 0, dose 1MedDRA: Vaccination site bruising — Feeling: Good · Site: Pain, SwellingFree text: Vaccine site showed a bruise color (black & blue) instantly. Was small in diameter initially. Now (11 hours later) its a larger 2 oval.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-28
Survey response — days 1–6 daily, dose 1MedDRA: Blister, Injection site bruising — Feeling: Good · Site: Pain, SwellingFree text: Black and blue area around injection site still there, but no larger than last night. Have some small blisters on fingers of right hand, but unclear if thats a reaction to the vaccine or to nickel (or other metals) in my coin change.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising, Swelling — Feeling: Good · Site: SwellingFree text: Swelling has decreased. Black and blue bruise at injection site is the same size.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-02
Survey response — days 1–6 daily, dose 1MedDRA: Contusion, Swelling — Feeling: Good · Site: SwellingFree text: Swelling almost gone (down to a faint lump). Black and blue (2 diameter oval) remains, darkish purple.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Contusion, Swelling — Feeling: Good · Site: SwellingFree text: Same as yesterday: swelling now a small bump. 2 diameter purplish bruise lingers.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Survey response — days 1–6 daily, dose 1MedDRA: Contusion, Nodule, Swelling — Feeling: Good · Site: SwellingFree text: Same as yesterday: swelling reduced to a smaller knot, black & blue bruise remains.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: SwellingFree text: Same as yesterday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Survey response — day 7, dose 1MedDRA: Impaired healing, Injection site bruising, Injection site discolouration, Vaccination site bruising — Feeling: GoodFree text: 2 bruise at vaccine site changing from purple to maroon and yellow. Healing, but VERY slowly.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-20
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2021-03-23
Dose 2 — Moderna
- 2021-03-23
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2021-03-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-25
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-04-06
- 2021-04-15
- 2021-04-27
- 2021-05-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-27 | Moderna | |
| 2 | 2021-03-23 | Moderna |
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): Vaccine site showed a bruise color (black & blue) instantly. Was small in diameter initially. Now (11 hours later) its a larger 2 oval.
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Black and blue area around injection site still there, but no larger than last night. Have some small blisters on fingers of right hand, but unclear if thats a reaction to the vaccine or to nickel (or other metals) in my coin change.
Systemic reaction (other): Swelling has decreased. Black and blue bruise at injection site is the same size.
Systemic reaction (other): Swelling almost gone (down to a faint lump). Black and blue (2 diameter oval) remains, darkish purple.
Systemic reaction (other): Same as yesterday: swelling now a small bump. 2 diameter purplish bruise lingers.
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Same as yesterday: swelling reduced to a smaller knot, black & blue bruise remains.
Systemic reaction (other): Same as yesterday.
Release 5 — day 7, dose 1
Systemic reaction (other): 2 bruise at vaccine site changing from purple to maroon and yellow. Healing, but VERY slowly.
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 |
|---|---|---|---|---|
| SRO | Blister | ✓ | ✓ | ✓ |
| SRO | Contusion | ✓ | ✓ | ✓ |
| SRO | Impaired healing | · | · | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Injection site discolouration | ✓ | ✓ | ○ |
| SRO | Nodule | ✓ | ✓ | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Vaccination site bruising | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release