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647-10807-93978

2 vaccinations 8 coded responses 15 check-ins 8 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
750 / TX
Registered
2021-10-19
Relationship
Self
Race
White
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-02-11
    Dose 2 — Moderna
  2. 2021-10-18
    Dose 3 — Moderna
  3. 2021-10-19
    Registered in v-safe
  4. 2021-10-19
    Survey response — days 1–6 daily, dose 3
    MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling · Fever
    Free text: Just don't feel 100%
    MedDRA releases: 2024-11 · check-in free text available
  5. 2021-10-20
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site erythema, Vaccine positive rechallenge — Feeling: Good · Site: Redness, Swelling
    Free text: The red door in the arm is twice the size as the one I had on second dose
    MedDRA releases: 2024-11 · check-in free text available
  6. 2021-10-21
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site erythema — Feeling: Good · Site: Redness, Swelling, Itching
    Free text: The red spot in the injection área us about 4" round or at least twice as big as the one I had after second dose
    MedDRA releases: 2024-11 · check-in free text available
  7. 2021-10-22
    Survey response — days 1–6 daily, dose 3
    MedDRA: Erythema, Pruritus, Swelling — Feeling: Good · Site: Redness, Swelling, Itching
    Free text: Itching and redness continues still a little swollen
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-10-23
    Survey response — days 1–6 daily, dose 3
    MedDRA: Rash — Feeling: Good · Site: Redness, Swelling, Itching
    Free text: The rash has extended somewhat.
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-10-24
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site erythema, Injection site pruritus — Feeling: Good · Site: Redness, Itching
    Free text: The itching has gotten somewhat better and not as red on site of shot
    MedDRA releases: 2024-11 · check-in free text available
  10. 2021-10-25
    Health check-in — day 7, dose 3
    Feeling: Good · Site: Redness, Itching · None
    Adult check-in
  11. 2021-11-01
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  12. 2021-11-08
    Survey response — day 21, dose 3
    MedDRA: Nasopharyngitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: I had a cold
    MedDRA releases: 2024-11 · check-in free text available
  13. 2021-11-08
    Report sent to call center — day 21, dose 3
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  14. 2021-11-10
  15. 2021-11-15
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  16. 2021-11-23
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  17. 2021-12-01
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  18. 2022-01-17
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  19. 2022-04-18
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  20. 2022-10-18
    Survey response — 12 months, dose 3
    MedDRA: Retinal haemorrhage — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Small eye hemorrhage on retine
    MedDRA releases: 2024-11 · check-in free text available
  21. 2022-10-18
    Report sent to call center — 12 months, dose 3
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  22. 2022-10-19
  23. 2022-10-19

Vaccinations

DoseDateManufacturerCo-administered
22021-02-11Moderna No
32021-10-18Moderna No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 3

2021-10-19

Systemic reaction (other): Just don't feel 100%

2021-10-20

Systemic reaction (other): The red door in the arm is twice the size as the one I had on second dose

2021-10-21

Systemic reaction (other): The red spot in the injection área us about 4" round or at least twice as big as the one I had after second dose

2021-10-22

Systemic reaction (other): Itching and redness continues still a little swollen

2021-10-23

Systemic reaction (other): The rash has extended somewhat.

2021-10-24

Systemic reaction (other): The itching has gotten somewhat better and not as red on site of shot

Release 10 — day 21, dose 3

2021-11-08

Symptoms: I had a cold

Release 12 — 12 months, dose 3

2022-10-18

Symptoms: Small eye hemorrhage on retine

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

FieldPreferred term2021-092023-042024-11
SDNasopharyngitis · · ✓
SDRetinal haemorrhage · · ✓
SROAdverse reaction · · ✓
SROErythema · · ✓
SROInjection site erythema · · ✓
SROInjection site pruritus · · ✓
SROPruritus · · ✓
SRORash · · ✓
SROSwelling · · ✓
SROVaccine positive rechallenge · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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