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5AB-95396-84882

3 vaccinations 6 coded responses 26 check-ins 6 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
206 / MD
Registered
2021-04-22
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-26
    Dose 1 — Moderna
  2. 2021-04-22
    Registered in v-safe
  3. 2021-04-23
    Dose 2 — Moderna
  4. 2021-04-23
    Survey response — day 0, dose 2
    MedDRA: Pain in extremity — Feeling: Good · Site: Pain
    Free text: The arm pain only last about an hour. Feel fine now (5 hours later)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Headache, Sinus disorder — Feeling: Fair · Site: Redness, Itching · Headache
    Free text: The headache may have been weather related sinus issues
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · None
    Adult check-in
  7. 2021-04-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Itching · None
    Adult check-in
  8. 2021-04-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · None
    Adult check-in
  9. 2021-04-29
    Survey response — days 1–6 daily, dose 2
    MedDRA: Erythema — Feeling: Good · Site: Redness
    Free text: The redness has gone down significantly. There is no more pain or itching.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-30
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-05-07
    Survey response — day 14, dose 2
    MedDRA: Erythema, Feeling hot, Pruritus, Skin warm, Swelling, Urticaria — Feeling: Fair
    Free text: Developed a red raised area on my right hip. It started yesterday and has become a raised area about 2x3. Like a welt. It feels hot both internally and externally. It also itches. Not sure if its related to the shot but no other known re
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-14
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-05-21
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-05-28
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-06-06
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-07-25
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-10-23
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-10-26
    Dose 3 — Moderna
  19. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness
    Adult check-in
  20. 2021-10-31
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site reaction, Rash erythematous, Rash pruritic — Feeling: Good · Site: Redness, Itching · Fatigue or tiredness
    Free text: The rash surrounding the shot area has reduced greatly in redness and itching
    MedDRA releases: 2024-11 · check-in free text available
  21. 2021-11-01
    Survey response — days 1–6 daily, dose 3
    MedDRA: Rash — Feeling: Good · Site: Itching · Fatigue or tiredness
    Free text: Rash is much better on arm
    MedDRA releases: 2024-11 · check-in free text available
  22. 2021-11-02
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  23. 2021-11-09
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  24. 2021-11-16
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  25. 2021-11-23
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  26. 2021-11-30
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  27. 2021-12-07
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  28. 2022-01-25
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  29. 2022-04-26
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  30. 2022-10-26
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-26Moderna
22021-04-23Moderna
32021-10-26Moderna No

Free text

Release 7 — day 0, dose 2

2021-04-23

Systemic reaction (other): The arm pain only last about an hour. Feel fine now (5 hours later)

Release 7 — days 1–6 daily, dose 2

2021-04-25

Systemic reaction (other): The headache may have been weather related sinus issues

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): The redness has gone down significantly. There is no more pain or itching.

Release 8 — day 14, dose 2

2021-05-07

Symptoms: Developed a red raised area on my right hip. It started yesterday and has become a raised area about 2x3. Like a welt. It feels hot both internally and externally. It also itches. Not sure if its related to the shot but no other known re

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): The rash surrounding the shot area has reduced greatly in redness and itching

2021-11-01

Systemic reaction (other): Rash is much better on arm

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
SDErythema ✓ ✓ ✓
SDFeeling hot ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDSkin warm ✓ ✓ ✓
SDSwelling ✓ ✓ ✓
SDUrticaria ✓ ✓ ✓
SROErythema ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROInjection site reaction · · ✓
SROPain in extremity ✓ ✓ ✓
SRORash · · ✓
SRORash erythematous · · ✓
SRORash pruritic · · ✓
SROSinus disorder ✓ ✓ ✓

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