5SH-23624-12324
3 vaccinations
4 coded responses
30 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 847 / UT
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-11
Registered in v-safe
-
2021-02-11
Dose 1 — Moderna
- 2021-02-11
-
2021-02-12
Survey response — days 1–6 daily, dose 1MedDRA: Erythema, Immunisation reaction, Injection site rash — Feeling: Good · Site: Redness, SwellingFree text: The rash around the shot site is 2 by 3.5 inches. Sharply demarcated and mild to moderately red. It resembles a mild case of the covid arm pictures seen on an internet search. I have photographed the area and marked the boundaries with sharpie. No other symptoms. not itchy. I am a Physician and I will observe carefully and report status to you on the next Vsafe query. Thank you.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Survey response — days 1–6 daily, dose 1MedDRA: Erythema, Tenderness — Feeling: Good · Site: Redness, SwellingFree text: The Shot related redness is decreasing. as is the tenderness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
-
2021-02-15
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: just mild persistent soreness in the shot area. else. no problem.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-27
- 2021-03-04
- 2021-03-11
-
2021-03-18
Dose 2 — Moderna
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-06-17
- 2021-09-16
-
2021-10-25
Dose 3 — Moderna
- 2021-10-25
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: PainFree text: no.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-27
- 2021-10-28
- 2021-10-30
- 2021-11-03
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-12-01
- 2021-12-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-11 | Moderna | |
| 2 | 2021-03-18 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): The rash around the shot site is 2 by 3.5 inches. Sharply demarcated and mild to moderately red. It resembles a mild case of the covid arm pictures seen on an internet search. I have photographed the area and marked the boundaries with sharpie. No other symptoms. not itchy. I am a Physician and I will observe carefully and report status to you on the next Vsafe query. Thank you.
Systemic reaction (other): The Shot related redness is decreasing. as is the tenderness.
Systemic reaction (other): just mild persistent soreness in the shot area. else. no problem.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): no.
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 | Erythema | ✓ | ✓ | ✓ |
| SRO | Immunisation reaction | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release