6EH-23306-17732
4 vaccinations
18 coded responses
41 check-ins
18 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 936 / CA
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
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2021-03-02
Registered in v-safe
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2021-03-02
Dose 1 — Moderna
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2021-03-02
Survey response — day 0, dose 1MedDRA: Injection site pain, Injection site warmth — Feeling: GoodFree text: Tenderness and some warmth at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Reaction to previous exposure to any vaccine — Feeling: GoodFree text: Just some tenderness at injection site. No different than when I get a flu shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
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2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: No longer feel any discomfort at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: GoodFree text: No discomfort or rash at injection site!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-09
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2021-03-16
Survey response — day 14, dose 1MedDRA: Medical counselling, Peripheral swelling, Skin discolouration, Skin warm — Feeling: Good · Be unable to do your normal daily activitiesFree text: On thurs. 3/11, I woke up with a swollen lump on my vaccination arm, that was hot,w/ discoloration going down my arm.,I took photos, if you want to see them; sent them to my PC dr. My arm has been getting better;?swelling and heat disappating.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
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2021-03-30
Dose 2 — Moderna
- 2021-03-30
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2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Injection site swelling, Pain, Pain in extremity — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Arm hurts when I try to lift it. Headache is at back of neck . I have been icing injection site to bring down swelling.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Survey response — days 1–6 daily, dose 2MedDRA: Pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Left Arm hurts when I try to lift it or lift anything heavy, i.e. pan to cookMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Injection site discolouration, Pain — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Colored area by injection site has spread; arm hurts when lifting or reaching overheadMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Injection site induration, Injection site warmth — Feeling: Good · Site: Redness · Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Hardness & heat at injection site have gone away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-07-01
- 2021-09-28
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2021-11-21
Dose 3 — Moderna
- 2022-03-30
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2022-05-05
Dose 4 — Moderna
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2022-05-06
Survey response — days 1–6 daily, dose 4MedDRA: Injection site warmth — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Heat @ injection site.MedDRA releases: 2024-11 · check-in free text available
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2022-05-07
Survey response — days 1–6 daily, dose 4MedDRA: Injection site induration, Injection site rash — Feeling: Good · Site: Redness, Swelling · Fatigue or tirednessFree text: Injection site is hard to touch and I do have a rash thereMedDRA releases: 2024-11 · check-in free text available
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2022-05-08
Survey response — days 1–6 daily, dose 4MedDRA: Injection site induration, Rash — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessFree text: Hardness in area of injection site and rashMedDRA releases: 2024-11 · check-in free text available
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2022-05-09
Survey response — days 1–6 daily, dose 4MedDRA: Rash — Feeling: Good · Fatigue or tirednessFree text: Rash is disappearing; arm doesn't hurt or feel sore at injection site.MedDRA releases: 2024-11 · check-in free text available
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2022-05-10
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue, Injection site erythema, Injection site swelling, Rash — Feeling: Good · Fatigue or tirednessFree text: Rash has gone!!! I still feel tired, but redness and swelling at injection site is gone!MedDRA releases: 2024-11 · check-in free text available
- 2022-05-11
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2022-05-12
Survey response — day 7, dose 4MedDRA: Fatigue — Feeling: GoodFree text: Feeling less tiredMedDRA releases: 2024-11 · check-in free text available
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2022-05-19
Survey response — day 14, dose 4MedDRA: Back pain, Chest discomfort, Cough, Musculoskeletal chest pain, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Tested Positive for COVID-19 on Tues 5/17/2022. Started getting sick Friday 5/13/2022 with sore throat, cough. Fever of 100.6 F on Sat 5/14/2022. Cough got worse 5/14 - 5/15; ribs and back hurt from so much coughing. Chest felt very heavy!MedDRA releases: 2024-11 · check-in free text available
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2022-05-19
Report sent to call center — day 14, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-05-20
Call successfulCompleted over the phone
- 2022-05-27
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2022-06-02
Survey response — day 28, dose 4MedDRA: Unevaluable event — Feeling: FairFree text: I am receiving 2 V-safe checkins- 1 - v.safe.cdc.gov/I/2/hQm7eEDKIFjUBEQ 2- v.safe.cdc.gov/I/2/QZm zEn59MCpjQQ See no 1 above for answers for today's 6 /2/2022 checkin. Can you combine these two different numbers to one?MedDRA releases: 2024-11 · check-in free text available
- 2022-06-10
- 2022-06-17
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2022-08-04
Survey response — 3 months, dose 4MedDRA: Hair dye user, Hypersensitivity, Pruritus, SARS-CoV-2 test positive — Feeling: GoodFree text: Allergic reaction to hair dye with severe itching for 5-7 days after dye color was applied? happened the last two times after I teste I positive for Covid in mid May 2022.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-03
- 2023-05-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna | |
| 3 | 2021-11-21 | Moderna | No |
| 4 | 2022-05-05 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): Tenderness and some warmth at injection site.
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Just some tenderness at injection site. No different than when I get a flu shot.
Systemic reaction (other): No longer feel any discomfort at injection site.
Systemic reaction (other): No discomfort or rash at injection site!
Release 5 — day 14, dose 1
Symptoms: On thurs. 3/11, I woke up with a swollen lump on my vaccination arm, that was hot,w/ discoloration going down my arm.,I took photos, if you want to see them; sent them to my PC dr. My arm has been getting better;?swelling and heat disappating.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Arm hurts when I try to lift it. Headache is at back of neck . I have been icing injection site to bring down swelling.
Systemic reaction (other): Left Arm hurts when I try to lift it or lift anything heavy, i.e. pan to cook
Systemic reaction (other): Colored area by injection site has spread; arm hurts when lifting or reaching overhead
Systemic reaction (other): Hardness & heat at injection site have gone away.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Heat @ injection site.
Systemic reaction (other): Injection site is hard to touch and I do have a rash there
Systemic reaction (other): Hardness in area of injection site and rash
Systemic reaction (other): Rash is disappearing; arm doesn't hurt or feel sore at injection site.
Systemic reaction (other): Rash has gone!!! I still feel tired, but redness and swelling at injection site is gone!
Release 11 — day 7, dose 4
Systemic reaction (other): Feeling less tired
Release 11 — day 14, dose 4
Symptoms: Tested Positive for COVID-19 on Tues 5/17/2022. Started getting sick Friday 5/13/2022 with sore throat, cough. Fever of 100.6 F on Sat 5/14/2022. Cough got worse 5/14 - 5/15; ribs and back hurt from so much coughing. Chest felt very heavy!
Release 11 — day 28, dose 4
Symptoms: I am receiving 2 V-safe checkins- 1 - v.safe.cdc.gov/I/2/hQm7eEDKIFjUBEQ 2- v.safe.cdc.gov/I/2/QZm zEn59MCpjQQ See no 1 above for answers for today's 6 /2/2022 checkin. Can you combine these two different numbers to one?
Release 12 — 3 months, dose 4
Symptoms: Allergic reaction to hair dye with severe itching for 5-7 days after dye color was applied? happened the last two times after I teste I positive for Covid in mid May 2022.
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 | Back pain | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Hair dye user | · | · | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Medical counselling | ✓ | ✓ | ✓ |
| SD | Musculoskeletal chest pain | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Skin discolouration | ✓ | ✓ | ✓ |
| SD | Skin warm | ✓ | ✓ | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site discolouration | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | · | · | ✓ |
| SRO | Injection site induration | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site rash | · | · | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Reaction to previous exposure to any vaccine | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release