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H7V-34511-51923

3 vaccinations 2 coded responses 24 check-ins 2 free-text entries 1 call case
Sex
Female
Age at first dose
31-35
ZIP prefix
232 / VA
Registered
2021-02-10
Relationship
Self
Race
White
Ethnicity
N/A
Registered dependents
RPR-22239-24286 Child or adolescent in my care · Male · 2022-10-07

Timeline

  1. 2021-02-09
    Dose 1 — Moderna
  2. 2021-02-10
    Registered in v-safe
  3. 2021-02-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain
    Adult check-in
  4. 2021-02-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-02-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Itching · None
    Adult check-in
  6. 2021-02-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-16
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Itching · None
    Adult check-in
  8. 2021-02-23
    Survey response — day 14, dose 1
    MedDRA: Injection site rash, Nodule, Rash erythematous — Feeling: Good
    Free text: I developed a vaccine knot and then a fairly big red rash on my arm at the injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-02
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-03-09
    Dose 2 — Moderna
  11. 2021-03-09
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  12. 2021-03-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  13. 2021-03-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  14. 2021-03-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-03-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-03-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-16
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-03-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-03-30
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-04-06
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-04-13
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-04-22
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-06-08
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-09-07
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-11-21
    Dose 3 — Moderna
  26. 2022-03-09
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2022-05-22
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  28. 2022-11-21
    Survey response — 12 months, dose 3
    MedDRA: Ageusia, Anosmia, Aphthous ulcer, Diarrhoea, Oropharyngeal pain, Secretion discharge, Sinusitis, Swollen tongue, Tongue ulceration — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Sinus infection with lots of mucus, loss of taste and smell, swollen tongue with sores and canker sores in mouth, extremely sore throat, diarrhea
    MedDRA releases: 2024-11 · check-in free text available
  29. 2022-11-21
    Report sent to call center — 12 months, dose 3
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  30. 2022-11-22
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-02-09Moderna
22021-03-09Moderna
32021-11-21Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-23

Symptoms: I developed a vaccine knot and then a fairly big red rash on my arm at the injection site

Release 12 — 12 months, dose 3

2022-11-21

Symptoms: Sinus infection with lots of mucus, loss of taste and smell, swollen tongue with sores and canker sores in mouth, extremely sore throat, diarrhea

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

FieldPreferred term2021-092023-042024-11
SDAgeusia · · ✓
SDAnosmia · · ✓
SDAphthous ulcer · · ✓
SDDiarrhoea · · ✓
SDInjection site rash ✓ ✓ ✓
SDNodule ✓ ✓ ✓
SDOropharyngeal pain · · ✓
SDRash erythematous ✓ ✓ ✓
SDSecretion discharge · · ✓
SDSinusitis · · ✓
SDSwollen tongue · · ✓
SDTongue ulceration · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release