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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

  1. 2021-03-23
    Dose 1 — Moderna
  2. 2021-04-20
    Dose 2 — Moderna
  3. 2021-04-21
    Registered in v-safe
  4. 2021-04-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Arthralgia, Headache, Injection site pruritus, Injection site swelling, Pre-existing disease, Rash pruritic, Self-medication, Sinus pain — Feeling: Good
    Free 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
  5. 2021-04-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  6. 2021-04-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  7. 2021-04-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease — Feeling: Good
    Free 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
  8. 2021-04-27
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-05-04
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-05-11
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-05-18
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-05-25
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-06-01
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-07-20
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-10-19
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  16. 2022-04-20
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-23Moderna
22021-04-20Moderna

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-23

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

2021-04-26

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

FieldPreferred term2021-092023-042024-11
SROArthralgia ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROInjection site pruritus ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SRORash pruritic ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓
SROSinus pain ✓ ✓ ✓

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