54S-97595-97304
2 vaccinations
4 coded responses
17 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 897 / NV
- Registered
- 2021-01-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-09
Registered in v-safe
-
2021-01-09
Dose 1 — Moderna
- 2021-01-09
-
2021-01-10
Survey response — days 1–6 daily, dose 1MedDRA: Abnormal dreams, Anxiety, Insomnia — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Fatigue or tirednessFree text: Anxiousness, loss of sleep, vivid dreamsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-11
-
2021-01-12
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
-
2021-01-23
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site rash, Injection site swelling, Injection site warmth — Feeling: GoodFree text: After a week and three days I developed a swollen, hot, rash on the arm where vaccine was administered. Almost like a hive. Lasted about 4 more days and then arm still has rash and itching.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-30
-
2021-02-06
Dose 2 — Moderna
-
2021-02-20
Survey response — day 14, dose 2MedDRA: Body temperature increased, Pruritus, Rash — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: 28 hours after shot became very ill with temp of 100-102. Lasted for about 48hrs. My arm had a rash but no hives this time. No symptoms since besides itching in vaccination area.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
-
2021-05-08
Survey response — 3 months, dose 2MedDRA: Vision blurred — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Blurry visionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-08
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-07
- 2022-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-09 | Moderna | |
| 2 | 2021-02-06 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Anxiousness, loss of sleep, vivid dreams
Release 2 — day 14, dose 1
Symptoms: After a week and three days I developed a swollen, hot, rash on the arm where vaccine was administered. Almost like a hive. Lasted about 4 more days and then arm still has rash and itching.
Release 4 — day 14, dose 2
Symptoms: 28 hours after shot became very ill with temp of 100-102. Lasted for about 48hrs. My arm had a rash but no hives this time. No symptoms since besides itching in vaccination area.
Release 8 — 3 months, dose 2
Symptoms: Blurry vision
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 | Body temperature increased | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Vision blurred | ✓ | ✓ | ✓ |
| SRO | Abnormal dreams | ✓ | ✓ | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release