5ZQ-26929-57404
2 vaccinations
4 coded responses
14 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 750 / TX
- Registered
- 2021-03-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-10
Dose 1 — Moderna
-
2021-03-26
Registered in v-safe
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2021-03-26
Survey response — day 14, dose 1MedDRA: Diarrhoea, Diarrhoea haemorrhagic, Erythema, Haematochezia, Injection site erythema, Injection site pain, Injection site rash, Injection site swelling, Limb mass, Pain, Pain in extremity, Rash, Skin discolouration, Swelling — Feeling: PoorFree text: CONCERNED. Dime size purplish lump appeared on lower arm. Clot?Day 8 redness at shot site, rash, swelling, soreness, diarreha with blood. Day 12 to present rash fading, swelling reduced, soreness continues in arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-06
Survey response — day 21, dose 1MedDRA: Contusion, Injection site haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Red blood accumulation around shot site. Clot or bruise type appearance on vaccine arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-06
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-07
Dose 2 — Moderna
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2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
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2021-04-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
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2021-04-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
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2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Feeling hot, Peripheral swelling, Rash, Unevaluable event — Feeling: Good · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Systemic reaction (other): Largish, red, hot, lump appeared on arm above elbow. Swelling, rash and heat on upper arm.alsorm · Healthcare visit (other): Ultrasound scheduled for tomorrowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-13
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-16
- 2021-04-21
- 2021-04-28
- 2021-05-07
- 2021-05-12
- 2021-05-21
- 2021-07-07
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2021-10-09
Survey response — 6 months, dose 2MedDRA: Fatigue, Nausea, Vomiting — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Tired, bouts of nausea with occasional vomitingMedDRA releases: 2024-11 · check-in free text available
- 2022-02-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Moderna | |
| 2 | 2021-04-07 | Moderna |
Call center
2 call center cases
2 unsuccessful
1 wait over 3 months for a first call
Free text
Release 6 — day 14, dose 1
Symptoms: CONCERNED. Dime size purplish lump appeared on lower arm. Clot?Day 8 redness at shot site, rash, swelling, soreness, diarreha with blood. Day 12 to present rash fading, swelling reduced, soreness continues in arm.
Release 7 — day 21, dose 1
Symptoms: Red blood accumulation around shot site. Clot or bruise type appearance on vaccine arm.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Largish, red, hot, lump appeared on arm above elbow. Swelling, rash and heat on upper arm.alsorm
Healthcare visit (other): Ultrasound scheduled for tomorrow
Release 10 — 6 months, dose 2
Symptoms: Tired, bouts of nausea with occasional vomiting
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 | Contusion | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ○ | ✓ | ○ |
| SD | Diarrhoea haemorrhagic | ✓ | · | ✓ |
| SD | Erythema | ○ | ✓ | ○ |
| SD | Fatigue | · | · | ✓ |
| SD | Haematochezia | ○ | ✓ | ○ |
| SD | Injection site erythema | ✓ | · | ✓ |
| SD | Injection site haemorrhage | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | · | ✓ |
| SD | Injection site rash | ✓ | · | ✓ |
| SD | Injection site swelling | ✓ | · | ✓ |
| SD | Limb mass | ✓ | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pain | ○ | ✓ | ○ |
| SD | Pain in extremity | ✓ | · | ✓ |
| SD | Rash | ○ | ✓ | ○ |
| SD | Skin discolouration | ✓ | · | ✓ |
| SD | Swelling | ○ | ✓ | ○ |
| SD | Vomiting | · | · | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release