6PK-66322-30457
4 vaccinations
12 coded responses
37 check-ins
12 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 030 / NH
- Registered
- 2021-02-08
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-04
Dose 1 — Moderna
-
2021-02-08
Registered in v-safe
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2021-02-08
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: Pain, Swelling, Itching · Muscle or body achesFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
- 2021-02-25
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2021-03-04
Dose 2 — Moderna
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2021-03-04
Health check-in — day 0, dose 2Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
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2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Injection site mass, Injection site pain — Feeling: Good · Site: Redness, Swelling, ItchingFree text: Lump at injection site only hurts when I rub my fingers over it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · DiarrheaAdult check-in
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2021-03-09
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus, Swelling — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: The swelling area is larger today. Its more like a little more than 4 in diameter (from 3.5 in diameter) and itches more than yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Survey response — days 1–6 daily, dose 2MedDRA: Erythema, Swelling — Feeling: Good · Site: Redness, Swelling, ItchingFree text: Swelling less and not as reddishMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Survey response — day 7, dose 2MedDRA: Mass — Feeling: Good · Site: Redness, Swelling, ItchingFree text: My lump is so much better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-10
- 2021-04-15
- 2021-06-03
- 2021-09-02
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2021-10-24
Dose 3 — Moderna
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2021-10-25
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tirednessFree text: No, not at this time.MedDRA releases: 2024-11 · check-in free text available
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2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Fatigue or tirednessFree text: The swelling is slightly look larger in diameter from 2.25" to 3.0" today. It doesn't appear to be higherMedDRA releases: 2024-11 · check-in free text available
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2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Pain, Pruritus — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: Even though the diameter increased from 3.0" yesterday to 3.3" today. It still hurts some and is itchy but not real bad.MedDRA releases: 2024-11 · check-in free text available
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2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Pain, Pruritus, Swelling — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: The swelling of the sight is a little larger today. From 3.3" yesterday to 3.5" today. Pain occurs even when I raise my arm and is itchier today.MedDRA releases: 2024-11 · check-in free text available
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2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Reaction to previous exposure to any vaccine, Swelling — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: Just like when I got shots 1&2, symptoms are reversing. The swelling is only 2.67" today down from 3.5" yesterday.MedDRA releases: 2024-11 · check-in free text available
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2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Erythema, Pain, Pruritus, Swelling — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: Swelling only 2_2/3" today. Pain, Redness & Itchy less than yesterdayMedDRA releases: 2024-11 · check-in free text available
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2021-11-01
Survey response — day 7, dose 3MedDRA: Pruritus, Swelling, Vaccine positive rechallenge — Feeling: Good · Site: Swelling, ItchingFree text: Just like my 1st & 2nd shots the swelling and itching are almost back to pre-booster. The swelling was only about 1 and 2/3" in diameter today (Sunday - October 31, 2021.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-07
- 2021-11-14
- 2021-11-21
- 2021-11-29
- 2021-12-05
- 2022-01-23
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2022-09-09
Dose 4 — ModernaCo-administered: Flu
- 2022-10-26
- 2022-10-26
- 2022-12-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-04 | Moderna | |
| 3 | 2021-10-24 | Moderna | No |
| 4 | 2022-09-09 | Moderna | Flu |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): No
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Lump at injection site only hurts when I rub my fingers over it.
Systemic reaction (other): The swelling area is larger today. Its more like a little more than 4 in diameter (from 3.5 in diameter) and itches more than yesterday
Systemic reaction (other): Swelling less and not as reddish
Release 5 — day 7, dose 2
Systemic reaction (other): My lump is so much better today.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): No, not at this time.
Systemic reaction (other): The swelling is slightly look larger in diameter from 2.25" to 3.0" today. It doesn't appear to be higher
Systemic reaction (other): Even though the diameter increased from 3.0" yesterday to 3.3" today. It still hurts some and is itchy but not real bad.
Systemic reaction (other): The swelling of the sight is a little larger today. From 3.3" yesterday to 3.5" today. Pain occurs even when I raise my arm and is itchier today.
Systemic reaction (other): Just like when I got shots 1&2, symptoms are reversing. The swelling is only 2.67" today down from 3.5" yesterday.
Systemic reaction (other): Swelling only 2_2/3" today. Pain, Redness & Itchy less than yesterday
Release 10 — day 7, dose 3
Systemic reaction (other): Just like my 1st & 2nd shots the swelling and itching are almost back to pre-booster. The swelling was only about 1 and 2/3" in diameter today (Sunday - October 31, 2021.
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 | Erythema | ✓ | ✓ | ✓ |
| SRO | Injection site mass | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Mass | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release