5J6-29678-76951
5 vaccinations
6 coded responses
60 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 171 / PA
- Registered
- 2021-02-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-20
Dose 1 — Moderna
-
2021-02-21
Registered in v-safe
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
-
2021-03-06
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site swelling, Muscle swelling, Pruritus — Feeling: GoodFree text: 8 days after my vaccine, my shot area became extremely itchy and I had a bump. Nothing major and it was barely visible by morning, then it went away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
-
2021-03-20
Dose 2 — Moderna
- 2021-03-21
-
2021-03-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
-
2021-03-23
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Breast pain, Coccydynia, Oedema peripheral — Feeling: Good · Site: SwellingFree text: Awakened early morning by a few areas that were painful.. tailbone and underarm area - below/front - top side of breast. On ejection arm side. Today underarm area still uncomfortable and swollen.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-05-01
-
2021-06-21
Survey response — 3 months, dose 2MedDRA: Diverticulitis, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Symptoms: May 24 was diagnosed with diverticulitis. (1st time). I am not saying it was due to the vaccine; I do not know what prompted it. · Healthcare visit (other): Plus visit with GIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-21
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-28
-
2021-07-13
Call successfulDoes not wish to fill out VAERS report
- 2021-09-18
-
2021-10-26
Dose 3 — Moderna
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2022-01-25
- 2022-04-26
-
2022-06-08
Dose 4 — Moderna
- 2022-06-09
-
2022-06-10
Survey response — days 1–6 daily, dose 4MedDRA: Lymph node pain, Lymphadenopathy, Reaction to previous exposure to any vaccine — Feeling: GoodFree text: A little swelling and tenderness in my armpit and outside of my breast in the arm I had the injection. (Lymph node area). I had this before with the Moderna vaccine.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-11
Survey response — days 1–6 daily, dose 4MedDRA: Lymph node pain, Lymphadenopathy — Feeling: GoodFree text: Still have tenderness and swelling in armpit area (lymph node); same arm as vaccine.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-12
Survey response — days 1–6 daily, dose 4MedDRA: Lymph node pain — Feeling: GoodFree text: Lymph node still a little tender, but not as bad as before.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-13
- 2022-06-14
- 2022-06-15
- 2022-06-22
- 2022-06-29
- 2022-07-08
- 2022-07-13
- 2022-07-20
- 2022-09-07
-
2022-09-23
Dose 5 — Moderna
- 2022-09-27
- 2022-09-28
- 2022-09-29
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-12-23
- 2023-03-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-20 | Moderna | |
| 2 | 2021-03-20 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-06-08 | Moderna | No |
| 5 | 2022-09-23 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 5 — day 14, dose 1
Symptoms: 8 days after my vaccine, my shot area became extremely itchy and I had a bump. Nothing major and it was barely visible by morning, then it went away.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Awakened early morning by a few areas that were painful.. tailbone and underarm area - below/front - top side of breast. On ejection arm side. Today underarm area still uncomfortable and swollen.
Release 9 — 3 months, dose 2
Symptoms: May 24 was diagnosed with diverticulitis. (1st time). I am not saying it was due to the vaccine; I do not know what prompted it.
Healthcare visit (other): Plus visit with GI
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): A little swelling and tenderness in my armpit and outside of my breast in the arm I had the injection. (Lymph node area). I had this before with the Moderna vaccine.
Systemic reaction (other): Still have tenderness and swelling in armpit area (lymph node); same arm as vaccine.
Systemic reaction (other): Lymph node still a little tender, but not as bad as before.
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Diverticulitis | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | · | ✓ |
| SD | Injection site swelling | ✓ | · | ✓ |
| SD | Muscle swelling | ○ | ✓ | ○ |
| SD | Pruritus | ○ | ✓ | ○ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Breast pain | ✓ | ✓ | ✓ |
| SRO | Coccydynia | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release