6CA-32665-64373
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
1 call case
- Sex
- —
- Age at first dose
- 26-30
- ZIP prefix
- 191 / PA
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Registered in v-safe
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2020-12-30
Dose 1 — Moderna
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2020-12-30
Health check-in — day 0, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2020-12-31
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2020-12-31
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2021-01-01
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-01-02
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-01-03
Survey response — days 1–6 daily, dose 1MedDRA: Angioedema, Self-medication — Feeling: Good · Site: PainFree text: Angioedema- small amount of swelling near right elbow. I take 10mg cetirizine everyday, 20mg when I have an allergic reaction like this. It usually occurs when my immune system is active (cold, flu, etc)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-04
- 2021-01-07
- 2021-01-13
- 2021-01-21
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2021-01-27
Dose 2 — Moderna
- 2021-01-27
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2021-01-28
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Itchiness at left inner wrist and left fingersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Muscle or body achesAdult check-in
- 2021-01-31
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2021-02-01
Survey response — days 1–6 daily, dose 2MedDRA: Erythema, Hypersensitivity, Joint swelling, Pre-existing disease, Pruritus — Feeling: Good · Headache, Muscle or body achesFree text: Small allergic reaction on inner right wrist, light swelling, redness, itchiness. Looks like my usual angioademaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
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2021-02-03
Survey response — day 7, dose 2MedDRA: Angioedema, Lip swelling, Pre-existing disease — Feeling: Good · Fatigue or tirednessFree text: Swollen lower lip, a symptom of my angioadema. It went down after taking cetirizine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
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2021-03-10
Survey response — day 42, dose 2MedDRA: Abdominal pain upper, Constipation — Feeling: Good · Be unable to do your normal daily activitiesFree text: Stomach pain, constipation, stomach cramping.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-28
- 2021-07-28
- 2022-01-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-27 | Moderna |
Call center
1 call center case
1 priority 2/3 (triaged and no follow up)
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Angioedema- small amount of swelling near right elbow. I take 10mg cetirizine everyday, 20mg when I have an allergic reaction like this. It usually occurs when my immune system is active (cold, flu, etc)
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Itchiness at left inner wrist and left fingers
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Small allergic reaction on inner right wrist, light swelling, redness, itchiness. Looks like my usual angioadema
Release 3 — day 7, dose 2
Systemic reaction (other): Swollen lower lip, a symptom of my angioadema. It went down after taking cetirizine.
Release 5 — day 42, dose 2
Symptoms: Stomach pain, constipation, stomach cramping.
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Constipation | ✓ | ✓ | ✓ |
| SRO | Angioedema | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Joint swelling | ✓ | ✓ | ✓ |
| SRO | Lip swelling | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release