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6KW-59408-06149

3 vaccinations 9 coded responses 23 check-ins 9 free-text entries 0 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
068 / CT
Registered
2021-02-04
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-06
    Dose 1 — Moderna
  2. 2021-02-03
    Dose 2 — Moderna
  3. 2021-02-04
    Registered in v-safe
  4. 2021-02-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Rash — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site
    Free text: 3/4 days after 1st injection a very mild rash developed on my neck..only lasted very briefly and posed no immediate concern. Has not reoccurred. Not sure if even related to injection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness · Abdominal pain
    Free text: Dizziness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Pain, Swelling
    Free text: Pain and swelling in my under arm in the arm the 2nd injection was given
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oedema peripheral — Feeling: Good · Site: Pain
    Free text: Mild swelling/tenderness under my arm in the arm that injection was given
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-02-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-02-10
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-02-17
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-08-04
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-10-28
    Dose 3 — Pfizer-BioNTech
  14. 2021-10-29
    Survey response — days 1–6 daily, dose 3
    MedDRA: Paraesthesia — Feeling: Good · Muscle or body aches
    Free text: Tingling of the arm and fingers
    MedDRA releases: 2024-11 · check-in free text available
  15. 2021-10-30
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: Underarm pain and swelling
    MedDRA releases: 2024-11 · check-in free text available
  16. 2021-10-31
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Muscle or body aches
    Free text: Underarm pain and swelling
    MedDRA releases: 2024-11 · check-in free text available
  17. 2021-11-01
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Muscle or body aches
    Free text: Pain and swelling in armpit
    MedDRA releases: 2024-11 · check-in free text available
  18. 2021-11-02
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  19. 2021-11-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  20. 2021-11-04
    Survey response — day 7, dose 3
    MedDRA: Oral mucosal eruption — Feeling: Good · Rash, not including the immediate area around the injection site
    Free text: Not sure if even related but rash around my mouth
    MedDRA releases: 2024-11 · check-in free text available
  21. 2021-11-11
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  22. 2021-11-18
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  23. 2021-11-25
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  24. 2021-12-02
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  25. 2021-12-09
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  26. 2022-01-29
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  27. 2022-04-28
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-06Moderna
22021-02-03Moderna
32021-10-28Pfizer-BioNTech No

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): 3/4 days after 1st injection a very mild rash developed on my neck..only lasted very briefly and posed no immediate concern. Has not reoccurred. Not sure if even related to injection

2021-02-05

Systemic reaction (other): Dizziness

2021-02-06

Systemic reaction (other): Pain and swelling in my under arm in the arm the 2nd injection was given

2021-02-07

Systemic reaction (other): Mild swelling/tenderness under my arm in the arm that injection was given

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): Tingling of the arm and fingers

2021-10-30

Systemic reaction (other): Underarm pain and swelling

2021-10-31

Systemic reaction (other): Underarm pain and swelling

2021-11-01

Systemic reaction (other): Pain and swelling in armpit

Release 10 — day 7, dose 3

2021-11-04

Systemic reaction (other): Not sure if even related but rash around my mouth

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
SROAxillary pain ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROOedema peripheral ✓ ✓ ✓
SROOral mucosal eruption · · ✓
SROParaesthesia · · ✓
SRORash ✓ ✓ ✓

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

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