4XZ-95465-19748
5 vaccinations
22 coded responses
64 check-ins
22 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 207 / MD
- Registered
- 2021-04-12
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-09
Dose 1 — Moderna
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2021-04-12
Registered in v-safe
- 2021-04-12
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2021-04-13
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
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2021-04-15
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus — Feeling: GoodFree text: Periodic itching all over body.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Survey response — day 7, dose 1MedDRA: Pruritus — Feeling: GoodFree text: Periodic/mild itching over entire body.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
- 2021-04-30
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2021-05-07
Dose 2 — Moderna
- 2021-05-07
- 2021-05-08
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2021-05-09
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pruritus, Pruritus, Self-medication — Feeling: Good · Site: ItchingFree text: Im also experiencing itching other than at the injection site. Took Benadryl that relieved the it. Feeling much better now!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-10
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus — Feeling: GoodFree text: Im experiencing mild itching over my body. However, not bad enough to take Benadryl.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-11
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-12
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-13
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-06-04
- 2021-06-11
- 2021-06-18
- 2021-08-06
- 2021-11-05
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2021-12-13
Dose 3 — Moderna
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2021-12-13
Survey response — day 0, dose 3MedDRA: Cough, Immediate post-injection reaction, Lacrimation increased — Feeling: GoodFree text: I had a coughing spell during the 15-minute recovery. I stepped outside to drink a bottle of water and suck on cough drops. I also experienced watery eyes for about 30 minutes or so.MedDRA releases: 2024-11 · check-in free text available
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2021-12-14
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
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2021-12-15
Survey response — days 1–6 daily, dose 3MedDRA: Chills, Headache, Self-medication — Feeling: Good · Site: Pain, Swelling, ItchingFree text: I experienced chills and a slight headache last night for a few hours. I applied a heating pad to my body and took a Tylenol. Felt better when I woke up this morning.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-16
- 2021-12-17
- 2021-12-18
- 2021-12-19
- 2021-12-20
- 2021-12-27
- 2022-01-03
- 2022-01-10
- 2022-01-17
- 2022-01-24
- 2022-03-14
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2022-05-02
Dose 4 — Moderna
- 2022-05-02
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2022-05-03
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
- 2022-05-04
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2022-05-05
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
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2022-05-06
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
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2022-05-07
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
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2022-05-08
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
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2022-05-09
Survey response — day 7, dose 4MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
- 2022-05-16
- 2022-05-23
- 2022-05-30
- 2022-06-06
- 2022-06-13
- 2022-08-01
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2022-10-07
Dose 5 — Moderna
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2022-10-08
Survey response — days 1–6 daily, dose 5MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: DizzinessMedDRA releases: 2024-11 · check-in free text available
- 2022-10-09
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2022-10-10
Survey response — days 1–6 daily, dose 5MedDRA: Dizziness — Feeling: Fair · Fatigue or tirednessFree text: Intermittent dizzinessMedDRA releases: 2024-11 · check-in free text available
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2022-10-11
Survey response — days 1–6 daily, dose 5MedDRA: Dizziness — Feeling: GoodFree text: Lightheadedness for a few seconds to a minuteMedDRA releases: 2024-11 · check-in free text available
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2022-10-12
Survey response — days 1–6 daily, dose 5MedDRA: Dizziness — Feeling: GoodFree text: Lightheadedness from a few seconds to a couple of minutesMedDRA releases: 2024-11 · check-in free text available
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2022-10-13
Survey response — days 1–6 daily, dose 5MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
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2022-10-14
Survey response — day 7, dose 5MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-11-18
- 2023-01-06
- 2023-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-09 | Moderna | |
| 2 | 2021-05-07 | Moderna | |
| 3 | 2021-12-13 | Moderna | No |
| 4 | 2022-05-02 | Moderna | No |
| 5 | 2022-10-07 | Moderna | No |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Periodic itching all over body.
Release 7 — day 7, dose 1
Systemic reaction (other): Periodic/mild itching over entire body.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Im also experiencing itching other than at the injection site. Took Benadryl that relieved the it. Feeling much better now!
Systemic reaction (other): Im experiencing mild itching over my body. However, not bad enough to take Benadryl.
Systemic reaction (other): None
Systemic reaction (other): None
Systemic reaction (other): None
Release 10 — day 0, dose 3
Systemic reaction (other): I had a coughing spell during the 15-minute recovery. I stepped outside to drink a bottle of water and suck on cough drops. I also experienced watery eyes for about 30 minutes or so.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I experienced chills and a slight headache last night for a few hours. I applied a heating pad to my body and took a Tylenol. Felt better when I woke up this morning.
Release 11 — days 1–6 daily, dose 4
Release 11 — day 7, dose 4
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Dizziness
Systemic reaction (other): Intermittent dizziness
Systemic reaction (other): Lightheadedness for a few seconds to a minute
Systemic reaction (other): Lightheadedness from a few seconds to a couple of minutes
Release 12 — day 7, dose 5
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 | Chills | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Immediate post-injection reaction | · | · | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Lacrimation increased | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release