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
-
2021-01-19
Dose 1 — Moderna
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2021-01-28
Registered in v-safe
- 2021-01-28
- 2021-02-02
- 2021-02-09
-
2021-02-16
Dose 2 — Moderna
- 2021-02-16
-
2021-02-18
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema — Feeling: Good · Site: RednessFree text: One pink spot approximately 2 inches near the injection sitenjMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity — Feeling: Good · Muscle or body achesFree text: A pink splotch fairly close to site and mild soreness upper armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-20
Survey response — days 1–6 daily, dose 2MedDRA: Erythema, Pain in extremity — Feeling: GoodFree 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
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2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Injection site reaction, Rash macular — Feeling: GoodFree text: Pink blotch that was near site now goneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Rash macular — Feeling: GoodFree text: The pink splotch I had a few days ago has disappeared I am perfectly fineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-23
Survey response — day 7, dose 2MedDRA: No adverse event — Feeling: GoodFree text: Everything is goodMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
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2021-05-18
Survey response — 3 months, dose 2MedDRA: Hypersensitivity, Pre-existing disease, Rhinorrhoea, Sneezing — Feeling: GoodFree 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 sneezingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-19
- 2022-02-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-16 | Moderna |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): One pink spot approximately 2 inches near the injection sitenj
Systemic reaction (other): A pink splotch fairly close to site and mild soreness upper arm
Systemic reaction (other): Pink splotch larger than it originally was ,close to site. Doesnt hurt or itch very slight soreness in upper arm.
Systemic reaction (other): Pink blotch that was near site now gone
Systemic reaction (other): The pink splotch I had a few days ago has disappeared I am perfectly fine
Release 4 — day 7, dose 2
Systemic reaction (other): Everything is good
Release 8 — 3 months, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site reaction | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Rash macular | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release