6XY-86254-51899
1 vaccination
4 coded responses
16 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 300 / GA
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-22
Registered in v-safe
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2021-01-22
Dose 1 — Moderna
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2021-01-22
Health check-in — day 0, dose 1Feeling: Fair · Site: Itching · Rash, not including the immediate area around the injection siteAdult check-in
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2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus, Self-medication — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection siteFree text: Took Tylenol to m last night and a Benadryl about 3:00 today. Was trying not to take Benadryl today but felt itchy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Self-medication — Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Needed to take a Benadryl this after. Took Tylenol pm last nightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Rash is now so slight it is hard to see.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-26
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2021-01-27
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Nausea, Vomiting · Be unable to do your normal daily activitiesAdult check-in
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2021-01-28
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-29
- 2021-02-06
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-04-23
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2021-07-23
Survey response — 6 months, dose 1MedDRA: Office visit, Peripheral swelling, Rash, Reaction to previous exposure to any vaccine — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Rash due to second dose of vaccine I took last week. This time j and j due to dr being concerned about another dose of moderna due to hives. Since seeing dr cannot get rings on hands.feels like arthritis. · Healthcare visit (other): Dr officeMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-07-23
Report sent to call center — 6 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-02
- 2022-01-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Took Tylenol to m last night and a Benadryl about 3:00 today. Was trying not to take Benadryl today but felt itchy.
Systemic reaction (other): Needed to take a Benadryl this after. Took Tylenol pm last night
Systemic reaction (other): Rash is now so slight it is hard to see.
Release 9 — 6 months, dose 1
Symptoms: Rash due to second dose of vaccine I took last week. This time j and j due to dr being concerned about another dose of moderna due to hives. Since seeing dr cannot get rings on hands.feels like arthritis.
Healthcare visit (other): Dr office
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Peripheral swelling | ✓ | · | ✓ |
| SD | Rash | ✓ | · | ✓ |
| SD | Reaction to previous exposure to any vaccine | ✓ | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release