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4VU-35055-85772

2 vaccinations 7 coded responses 18 check-ins 7 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
021 / MA
Registered
2021-01-28
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-19
    Dose 1 — Moderna
  2. 2021-01-28
    Registered in v-safe
  3. 2021-01-28
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-02-02
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-02-09
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-02-16
    Dose 2 — Moderna
  7. 2021-02-16
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  8. 2021-02-18
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site erythema — Feeling: Good · Site: Redness
    Free text: One pink spot approximately 2 inches near the injection sitenj
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-19
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pain in extremity — Feeling: Good · Muscle or body aches
    Free text: A pink splotch fairly close to site and mild soreness upper arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-20
    Survey response — days 1–6 daily, dose 2
    MedDRA: Erythema, Pain in extremity — Feeling: Good
    Free text: Pink splotch larger than it originally was ,close to site. Doesnt hurt or itch very slight soreness in upper arm.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-21
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site reaction, Rash macular — Feeling: Good
    Free text: Pink blotch that was near site now gone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Rash macular — Feeling: Good
    Free text: The pink splotch I had a few days ago has disappeared I am perfectly fine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-02-23
    Survey response — day 7, dose 2
    MedDRA: No adverse event — Feeling: Good
    Free text: Everything is good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-02
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-03-09
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-03-16
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-03-23
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-30
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-05-18
    Survey response — 3 months, dose 2
    MedDRA: Hypersensitivity, Pre-existing disease, Rhinorrhoea, Sneezing — Feeling: Good
    Free text: Have had a runny nose for the past four or five days Doesnt feel like a cold and doesnt feel like an allergy usually my allergies make my ears and throat itch and Im not usually allergic to spring things usually Fall allergies also sneezing
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-08-19
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2022-02-16
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-19Moderna
22021-02-16Moderna

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-18

Systemic reaction (other): One pink spot approximately 2 inches near the injection sitenj

2021-02-19

Systemic reaction (other): A pink splotch fairly close to site and mild soreness upper arm

2021-02-20

Systemic reaction (other): Pink splotch larger than it originally was ,close to site. Doesnt hurt or itch very slight soreness in upper arm.

2021-02-21

Systemic reaction (other): Pink blotch that was near site now gone

2021-02-22

Systemic reaction (other): The pink splotch I had a few days ago has disappeared I am perfectly fine

Release 4 — day 7, dose 2

2021-02-23

Systemic reaction (other): Everything is good

Release 8 — 3 months, dose 2

2021-05-18

Symptoms: Have had a runny nose for the past four or five days Doesnt feel like a cold and doesnt feel like an allergy usually my allergies make my ears and throat itch and Im not usually allergic to spring things usually Fall allergies also sneezing

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
SDHypersensitivity ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓
SDSneezing ✓ ✓ ✓
SROErythema ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site reaction ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SRORash macular ✓ ✓ ✓

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