GN6-30555-63473
4 vaccinations
4 coded responses
10 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 777 / TX
- Registered
- 2022-04-23
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Dose 1 — Moderna
-
2021-04-28
Dose 2 — Moderna
-
2021-09-29
Dose 3 — Moderna
-
2022-04-22
Dose 4 — Moderna
-
2022-04-23
Registered in v-safe
-
2022-04-23
Survey response — days 1–6 daily, dose 4MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Redness, SwellingFree text: swollen under arm on side of injectionMedDRA releases: 2024-11 · check-in free text available
-
2022-04-24
Survey response — days 1–6 daily, dose 4MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Redness, SwellingFree text: swelling under left arm where injection was givenMedDRA releases: 2024-11 · check-in free text available
-
2022-04-25
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, SwellingFree text: lymph node under arm ,same side as injection swollenMedDRA releases: 2024-11 · check-in free text available
- 2022-04-30
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
-
2022-07-22
Survey response — 3 months, dose 4MedDRA: Malaise, Office visit, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Tested positive for Covid, had all symptoms · Healthcare visit (other): Drs officeMedDRA releases: 2024-11 · check-in free text available
-
2022-07-22
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
-
2022-07-25
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | No |
| 2 | 2021-04-28 | Moderna | No |
| 3 | 2021-09-29 | Moderna | No |
| 4 | 2022-04-22 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): swollen under arm on side of injection
Systemic reaction (other): swelling under left arm where injection was given
Systemic reaction (other): lymph node under arm ,same side as injection swollen
Release 12 — 3 months, dose 4
Symptoms: Tested positive for Covid, had all symptoms
Healthcare visit (other): Drs 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 | Malaise | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release