4S6-27646-65475
2 vaccinations
6 coded responses
21 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 919 / CA
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
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2021-01-15
Survey response — day 0, dose 1MedDRA: Dizziness, Immediate post-injection reaction — Feeling: GoodFree text: Lightheaded right after receiving vaccine but subsided 30 mins after.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-16
- 2021-01-17
- 2021-01-19
- 2021-01-22
-
2021-01-29
Survey response — day 14, dose 1MedDRA: Contusion, Pruritus, Rash — Feeling: FairFree text: Rash about 2-3 inches below the injection sight. Looks like a bite then bruised. Very itchy but has calmed down. Its been about a week now. I didnt know that could be fr the vaccination but my friend had the same thing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
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2021-02-12
Dose 2 — Moderna
- 2021-02-12
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2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: LightheadedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Light headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
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2021-02-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Rash, not including the immediate area around the injection siteAdult check-in
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2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-02-18
- 2021-02-19
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2021-02-26
Survey response — day 14, dose 2MedDRA: Injection site pruritus — Feeling: GoodFree text: Itchy near the injection sight.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-12
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2021-03-19
Survey response — day 35, dose 2MedDRA: Dizziness, Ear pain, Headache, Pre-existing disease, Vertigo, Visual impairment — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Vertigo; dizzy, lightheaded, weird vision stuff, feels best to lay down, right ear and head hurts. H/O vertigo 2 years agoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
- 2021-05-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): Lightheaded right after receiving vaccine but subsided 30 mins after.
Release 3 — day 14, dose 1
Symptoms: Rash about 2-3 inches below the injection sight. Looks like a bite then bruised. Very itchy but has calmed down. Its been about a week now. I didnt know that could be fr the vaccination but my friend had the same thing.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Lightheaded
Systemic reaction (other): Light headache
Release 4 — day 14, dose 2
Symptoms: Itchy near the injection sight.
Release 5 — day 35, dose 2
Symptoms: Vertigo; dizzy, lightheaded, weird vision stuff, feels best to lay down, right ear and head hurts. H/O vertigo 2 years ago
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 | Contusion | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Ear pain | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SD | Visual impairment | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release