EL9-10621-01478
3 vaccinations
1 coded response
2 check-ins
1 free-text entry
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 300 / GA
- Registered
- 2021-03-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Dose 1 — Moderna
-
2021-03-27
Registered in v-safe
-
2021-03-27
Survey response — day 7, dose 1MedDRA: Urticaria — Feeling: Fair · Rash, not including the immediate area around the injection siteFree text: raised multi-focal, fluid-filled, pruritic welts on feetMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-22
Dose 2 — Moderna
-
2021-04-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-27
Dose 3 — Pfizer-BioNTech
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-22 | Moderna | |
| 3 | 2021-10-27 | Pfizer-BioNTech | No |
Free text
Release 6 — day 7, dose 1
Systemic reaction (other): raised multi-focal, fluid-filled, pruritic welts on feet
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 | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release