9MT-22702-64791
5 vaccinations
2 coded responses
24 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 017 / MA
- Registered
- 2021-04-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
74X-25509-25768
Child or adolescent in my care · Male · 2022-07-01
Timeline
-
2021-01-13
Dose 1 — Moderna
-
2021-02-10
Dose 2 — Moderna
-
2021-04-23
Registered in v-safe
-
2021-05-13
Survey response — 3 months, dose 2MedDRA: Pruritus, Rash, Rash erythematous, Urticaria — Feeling: GoodFree text: Full body rash of raised red welts. Very very itchy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-11
-
2021-10-08
Dose 3 — Moderna
- 2021-10-26
- 2021-10-29
- 2021-11-07
- 2021-11-12
- 2021-11-21
-
2022-01-07
Survey response — 3 months, dose 3MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend schoolFree text: COVID +MedDRA releases: 2024-11 · check-in free text available
- 2022-04-08
-
2022-08-05
Dose 4 — Moderna
- 2022-08-05
-
2022-08-06
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2022-08-07
- 2022-08-08
- 2022-08-09
- 2022-08-10
- 2022-08-11
- 2022-08-12
- 2022-08-19
- 2022-08-26
- 2022-09-02
- 2022-09-10
- 2022-09-18
- 2022-11-05
-
2022-12-22
Dose 5 — Moderna
- 2023-02-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-10-08 | Moderna | No |
| 4 | 2022-08-05 | Moderna | No |
| 5 | 2022-12-22 | Moderna | No |
Free text
Release 8 — 3 months, dose 2
Symptoms: Full body rash of raised red welts. Very very itchy.
Release 10 — 3 months, dose 3
Symptoms: COVID +
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 |
|---|---|---|---|---|
| SD | COVID-19 | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release