6JK-61815-21847
2 vaccinations
2 coded responses
13 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 959 / CA
- Registered
- 2021-04-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-23
Dose 1 — Moderna
-
2021-04-20
Dose 2 — Moderna
-
2021-04-21
Registered in v-safe
-
2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Headache, Injection site pruritus, Injection site swelling, Pre-existing disease, Rash pruritic, Self-medication, Sinus pain — Feeling: GoodFree text: The 1st day and 2nd day headache, took tylenol, also had a pain like on my right side sinus straight line going up and down like a line until i took Tylenol with the headache. I was pretty achy in my joints and my arthritis elbow Thursday, Wednesday night I noticed one small itchy bump near the injection area, the next day at 5 pmi had several itchy bumps, similar to a poisen oak rash, they were not very visible to me. I could only feel them. But tiday there are tiny spots but they are no longer itchy and are almost gone and flat not bumpy. No more headache like the 2nd day, and 3rd day was the worst.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
- 2021-04-25
-
2021-04-26
Survey response — days 1–6 daily, dose 2MedDRA: Pre-existing disease — Feeling: GoodFree text: I take 1.5 trulicity shot 1 time weekly, and 1000mg metformin daily, i also take levothyroxine as i no longer have a thyroid, and had 1 parathyroid removed in 2016, and I take a blood thinner for blood clotting disorders.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-07-20
- 2021-10-19
- 2022-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-23 | Moderna | |
| 2 | 2021-04-20 | Moderna |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): The 1st day and 2nd day headache, took tylenol, also had a pain like on my right side sinus straight line going up and down like a line until i took Tylenol with the headache. I was pretty achy in my joints and my arthritis elbow Thursday, Wednesday night I noticed one small itchy bump near the injection area, the next day at 5 pmi had several itchy bumps, similar to a poisen oak rash, they were not very visible to me. I could only feel them. But tiday there are tiny spots but they are no longer itchy and are almost gone and flat not bumpy. No more headache like the 2nd day, and 3rd day was the worst.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): I take 1.5 trulicity shot 1 time weekly, and 1000mg metformin daily, i also take levothyroxine as i no longer have a thyroid, and had 1 parathyroid removed in 2016, and I take a blood thinner for blood clotting disorders.
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 |
|---|---|---|---|---|
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Sinus pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release