775-21573-77861
3 vaccinations
1 coded response
24 check-ins
1 free-text entry
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 194 / PA
- Registered
- 2021-07-09
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-07-07
Dose 1 — Moderna
-
2021-07-09
Registered in v-safe
- 2021-07-09
- 2021-07-10
- 2021-07-11
- 2021-07-12
- 2021-07-13
-
2021-07-16
Survey response — day 7, dose 1MedDRA: Injection site discolouration, Injection site erythema, Injection site pruritus, Injection site rash — Feeling: Good · Site: Redness, Swelling · Rash, not including the immediate area around the injection siteFree text: Sudden rash appeared on arm about an inch or so away from injection site. Was itchy and little dots first day, then turned into a reddish spot next day. Not itchy or painful. Could be unrelated to vaccine.MedDRA releases: 2024-11 · check-in free text available
- 2021-07-30
-
2021-08-06
Dose 2 — Moderna
- 2021-08-06
-
2021-08-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-08-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-08-09
- 2021-08-11
- 2021-08-13
- 2021-08-20
- 2021-08-27
- 2021-09-03
- 2021-09-10
- 2021-09-17
- 2021-11-05
-
2021-12-01
Dose 3 — Moderna
- 2022-01-10
- 2022-01-12
- 2022-03-02
- 2022-06-01
- 2022-12-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-07-07 | Moderna | No |
| 2 | 2021-08-06 | Moderna | No |
| 3 | 2021-12-01 | Moderna | No |
Free text
Release 9 — day 7, dose 1
Systemic reaction (other): Sudden rash appeared on arm about an inch or so away from injection site. Was itchy and little dots first day, then turned into a reddish spot next day. Not itchy or painful. Could be unrelated to vaccine.
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 | Injection site discolouration | · | · | ✓ |
| SRO | Injection site erythema | · | · | ✓ |
| SRO | Injection site pruritus | · | · | ✓ |
| SRO | Injection site rash | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release