5VG-11521-65444
4 vaccinations
7 coded responses
48 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 064 / CT
- 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
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-16
-
2021-01-23
Survey response — day 14, dose 1MedDRA: Injection site reaction, Injection site swelling, Rash erythematous, Rash pruritic — Feeling: GoodFree text: Day 10 I developed an expanding area of red and itchy rash on upper arm where injection was. Started the size of clementine, and was raised bumps. Ended up orange sized, warm x3 days. Now resolved.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-30
-
2021-02-06
Dose 2 — Moderna
- 2021-02-06
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Palpitations, Pelvic pain — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Mild palpitations, pelvic painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-09
-
2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: Good · Site: Pain, RednessFree text: Sore axilla x 3 daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-12
- 2021-02-13
-
2021-02-20
Survey response — day 14, dose 2MedDRA: Rash, Rash papular — Feeling: GoodFree text: Developed raised rash on RT shoulder blade at 7:30pm,day 12. Lasted 1 hr and dissapeared. No residual redness. Had shot #2 in RT arm. I mention because had shot #1 LT arm; rash developed after shot #1 on day 11 at 7:30pm. Both shots given @ 10:30am.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
- 2021-08-07
-
2021-11-09
Dose 3 — Moderna
- 2021-11-09
-
2021-11-10
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-11-11
Survey response — days 1–6 daily, dose 3MedDRA: Tenderness — Feeling: Good · Site: PainFree text: Axillary tenderness in shot armMedDRA releases: 2024-11 · check-in free text available
-
2021-11-12
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-14
- 2021-12-21
- 2022-02-08
- 2022-05-10
-
2022-10-28
Dose 4 — Moderna
- 2022-11-09
- 2022-11-09
- 2022-11-11
-
2022-11-19
Survey response — day 21, dose 4MedDRA: Adnexa uteri pain, Female reproductive tract disorder, Fluid retention — Feeling: Good · Be unable to do your normal daily activitiesFree text: Increased gynecological issues. Ovarian pain. Fluid retention. X4 daysMedDRA releases: 2024-11 · check-in free text available
- 2022-11-25
- 2022-12-02
- 2022-12-09
-
2023-01-29
Survey response — 3 months, dose 4MedDRA: Cough, Fatigue, Headache, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-09 | Moderna | |
| 2 | 2021-02-06 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
| 4 | 2022-10-28 | Moderna | No |
Free text
Release 2 — day 14, dose 1
Symptoms: Day 10 I developed an expanding area of red and itchy rash on upper arm where injection was. Started the size of clementine, and was raised bumps. Ended up orange sized, warm x3 days. Now resolved.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Mild palpitations, pelvic pain
Systemic reaction (other): Sore axilla x 3 days
Release 4 — day 14, dose 2
Symptoms: Developed raised rash on RT shoulder blade at 7:30pm,day 12. Lasted 1 hr and dissapeared. No residual redness. Had shot #2 in RT arm. I mention because had shot #1 LT arm; rash developed after shot #1 on day 11 at 7:30pm. Both shots given @ 10:30am. cut off by CDC
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Axillary tenderness in shot arm
Release 12 — day 21, dose 4
Symptoms: Increased gynecological issues. Ovarian pain. Fluid retention. X4 days
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 | Adnexa uteri pain | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Female reproductive tract disorder | · | · | ✓ |
| SD | Fluid retention | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site reaction | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Rash papular | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Pelvic pain | ✓ | ✓ | ✓ |
| SRO | Tenderness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release