6AP-27571-33954
2 vaccinations
4 coded responses
8 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 620 / IL
- Registered
- 2021-02-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-23
Dose 1 — Moderna
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2021-02-02
Registered in v-safe
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2021-02-02
Survey response — day 7, dose 1MedDRA: Injection site erythema, Injection site induration, Injection site nodule, Injection site pruritus, Injection site urticaria — Feeling: Good · Site: Pain, Redness, Swelling, Itching · HeadacheFree text: Red and itchy with hives this afternoon around injection site. Hard knot under injection site about the size of a large egg.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Survey response — day 14, dose 1MedDRA: Rash erythematous, Skin warm, Urticaria — Feeling: GoodFree text: The redness (rash - and hives if I itched it) spread to 8 inches in length and to 6 inches wide and was always quite warm or hot. I would put an ice pack on it and it would immediately help. Everything peaked yesterday and it is now going away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-13
Survey response — day 21, dose 1MedDRA: Erythema — Feeling: GoodFree text: The redness on my arm came back after being gone for a couple of days and got bigger than I reported last week. It stayed for a couple of days and went away. It's been gone for about 3 days now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-21
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2021-02-23
Dose 2 — Moderna
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2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Chest pain, Immunisation reaction, Musculoskeletal chest pain, Pain — Feeling: Good · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: 2/24/21-achy for 2 hours; 27 hours after vaccine. 2/25-2/27; moderate to severe chest, rib and back pain that would come and go in waves waxing and waning. I've never felt this particular kind of pain before. It was very strange. I also had covid arm again. I do not like this vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
- 2021-03-09
- 2021-03-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-23 | Moderna |
Free text
Release 3 — day 7, dose 1
Systemic reaction (other): Red and itchy with hives this afternoon around injection site. Hard knot under injection site about the size of a large egg.
Release 3 — day 14, dose 1
Symptoms: The redness (rash - and hives if I itched it) spread to 8 inches in length and to 6 inches wide and was always quite warm or hot. I would put an ice pack on it and it would immediately help. Everything peaked yesterday and it is now going away.
Release 4 — day 21, dose 1
Symptoms: The redness on my arm came back after being gone for a couple of days and got bigger than I reported last week. It stayed for a couple of days and went away. It's been gone for about 3 days now.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): 2/24/21-achy for 2 hours; 27 hours after vaccine. 2/25-2/27; moderate to severe chest, rib and back pain that would come and go in waves waxing and waning. I've never felt this particular kind of pain before. It was very strange. I also had covid arm again. I do not like this vaccine.
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 | Erythema | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Skin warm | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Immunisation reaction | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site induration | ✓ | ✓ | ✓ |
| SRO | Injection site nodule | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Injection site urticaria | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal chest pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release