5XA-18092-58233
4 vaccinations
8 coded responses
54 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 208 / MD
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
PVY-13234-89607
Child or adolescent in my care · Female · 2021-11-07
Timeline
-
2021-04-01
Registered in v-safe
-
2021-04-01
Dose 1 — Moderna
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-22
-
2021-04-29
Dose 2 — Moderna
-
2021-04-29
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-01
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-06-10
- 2021-07-29
- 2021-10-30
-
2021-12-06
Dose 3 — Moderna
-
2021-12-06
Survey response — day 0, dose 3MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, NauseaFree text: Lightheaded/dizzyMedDRA releases: 2024-11 · check-in free text available
-
2021-12-07
Survey response — days 1–6 daily, dose 3MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Dizziness/lightheadedMedDRA releases: 2024-11 · check-in free text available
-
2021-12-08
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: PainFree text: Underarm pain/swelling on same side of body as injectionMedDRA releases: 2024-11 · check-in free text available
-
2021-12-09
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain, Oedema peripheral — Feeling: GoodFree text: Swollen underarm/lymph pain on same side as injectionMedDRA releases: 2024-11 · check-in free text available
- 2021-12-10
- 2021-12-11
- 2021-12-12
- 2021-12-13
- 2021-12-20
- 2021-12-27
- 2022-01-03
- 2022-01-10
- 2022-01-17
- 2022-03-07
- 2022-06-06
-
2022-09-16
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-16
-
2022-09-17
Survey response — days 1–6 daily, dose 4MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Lymph node swelling and moderate underarm painMedDRA releases: 2024-11 · check-in free text available
-
2022-09-18
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, RednessFree text: Lymph node / under arm swelling on side where I received the shotMedDRA releases: 2024-11 · check-in free text available
-
2022-09-19
Survey response — days 1–6 daily, dose 4MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Pain, Redness, SwellingFree text: Minor lymph node/under arm pain on side where I received shot. Has definitely been tapering off in the few days since vaccination and no longer requiring pain meds.MedDRA releases: 2024-11 · check-in free text available
- 2022-09-20
- 2022-09-21
- 2022-09-23
- 2022-09-30
- 2022-10-07
- 2022-10-16
- 2022-10-21
- 2022-10-28
- 2022-12-16
-
2023-03-17
Survey response — 6 months, dose 4MedDRA: Lymph node pain, Oedema peripheral, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-17
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-04-29 | Moderna | |
| 3 | 2021-12-06 | Moderna | No |
| 4 | 2022-09-16 | Pfizer-BioNTech | Flu |
Call center
1 call center case
1 unsuccessful
Free text
Release 10 — day 0, dose 3
Systemic reaction (other): Lightheaded/dizzy
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Dizziness/lightheaded
Systemic reaction (other): Underarm pain/swelling on same side of body as injection
Systemic reaction (other): Swollen underarm/lymph pain on same side as injection
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Lymph node swelling and moderate underarm pain
Systemic reaction (other): Lymph node / under arm swelling on side where I received the shot
Systemic reaction (other): Minor lymph node/under arm pain on side where I received shot. Has definitely been tapering off in the few days since vaccination and no longer requiring pain meds.
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 | Unevaluable event | · | · | ✓ |
| SD | Lymph node pain | · | · | ✓ |
| SD | Oedema peripheral | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release