4RX-21394-78126
2 vaccinations
6 coded responses
27 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 385 / TN
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Registered in v-safe
-
2021-03-11
Dose 1 — Moderna
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
-
2021-04-09
Dose 2 — Moderna
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
-
2021-04-14
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: GoodFree text: Inflammation of right armpit (lymph node) to about golf ball size. Tissue is soft and movable.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Oedema peripheral — Feeling: GoodFree text: Swelling in right armpit.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-16
Survey response — day 7, dose 2MedDRA: Lymphadenopathy — Feeling: GoodFree text: Enlarged area in right armpit- appears to me to be a swollen lymph node about golf ball size.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
-
2021-04-30
Survey response — day 21, dose 2MedDRA: Fatigue, Paranasal sinus hypersecretion, Productive cough — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sinus drainage, phlegm, tired.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-07
Survey response — day 28, dose 2MedDRA: Pre-existing disease, Psoriasis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Psoriasis is flaring up after good progress on a new biologic medicine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
- 2021-05-21
- 2021-07-09
-
2021-10-08
Survey response — 6 months, dose 2MedDRA: Pyrexia, SARS-CoV-2 test — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professionalFree text: Symptoms: Low fever for two days. Possibly due to an injection site reaction to Taltz. · Healthcare visit (other): COVID-19 testMedDRA releases: 2024-11 · check-in free text available
-
2021-10-08
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)
- 2021-10-13
-
2021-10-14
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-09 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Inflammation of right armpit (lymph node) to about golf ball size. Tissue is soft and movable.
Systemic reaction (other): Swelling in right armpit.
Release 7 — day 7, dose 2
Systemic reaction (other): Enlarged area in right armpit- appears to me to be a swollen lymph node about golf ball size.
Release 8 — day 21, dose 2
Symptoms: Sinus drainage, phlegm, tired.
Release 8 — day 28, dose 2
Symptoms: Psoriasis is flaring up after good progress on a new biologic medicine.
Release 10 — 6 months, dose 2
Symptoms: Low fever for two days. Possibly due to an injection site reaction to Taltz.
Healthcare visit (other): COVID-19 test
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 | SARS-CoV-2 test | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Paranasal sinus hypersecretion | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Productive cough | ✓ | ✓ | ✓ |
| SD | Psoriasis | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release