5PZ-27564-07266
3 vaccinations
4 coded responses
34 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 488 / MI
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Dose 1 — Moderna
-
2021-04-01
Registered in v-safe
-
2021-04-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-14
-
2021-04-21
Survey response — day 21, dose 1MedDRA: Injection site pruritus, Injection site rash, Pain in extremity, Rash — Feeling: GoodFree text: Rash and pain on injection arm began 2 werks after injection. Started with mild itching and then mild rash over injection site and continuing about 6 inches below that. Pain a few days later like that of day after injection. Rash fading nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-28
-
2021-04-30
Dose 2 — Moderna
-
2021-05-05
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache · Be unable to work, Be unable to do your normal daily activitiesFree text: I am reporting sysmptoms from May 1 here. Day after 2nd shot. Most symptoms are now goneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-06
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Redness, Itching · Fever · Headache, Fatigue or tirednessFree text: Filling this in for day 2 post 2nd shot may 2bdMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-06-04
- 2021-06-11
- 2021-07-30
- 2021-10-31
-
2022-01-18
Dose 3 — Moderna
-
2022-01-20
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2022-01-21
- 2022-01-22
- 2022-01-23
- 2022-01-24
- 2022-01-25
- 2022-02-01
-
2022-02-08
Survey response — day 21, dose 3MedDRA: Body temperature increased, Myalgia — Feeling: Good · Be unable to do your normal daily activitiesFree text: 2 weeks after booster...100 degree fever for 24 hours and muscle aches. No known cause...no other symptomsMedDRA releases: 2024-11 · check-in free text available
- 2022-02-16
- 2022-02-24
- 2022-03-01
- 2022-04-19
- 2022-07-19
- 2023-01-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-30 | Moderna | |
| 3 | 2022-01-18 | Moderna | No |
Free text
Release 7 — day 21, dose 1
Symptoms: Rash and pain on injection arm began 2 werks after injection. Started with mild itching and then mild rash over injection site and continuing about 6 inches below that. Pain a few days later like that of day after injection. Rash fading now
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): I am reporting sysmptoms from May 1 here. Day after 2nd shot. Most symptoms are now gone
Systemic reaction (other): Filling this in for day 2 post 2nd shot may 2bd
Release 11 — day 21, dose 3
Symptoms: 2 weeks after booster...100 degree fever for 24 hours and muscle aches. No known cause...no other symptoms
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 | Myalgia | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release