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J4V-29382-80066

4 vaccinations 1 coded response 35 check-ins 1 free-text entry 0 call cases
Sex
Female
Age at first dose
41-45
ZIP prefix
791 / TX
Registered
2020-12-30
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino
Registered dependents
HKG-22286-11799 Child or adolescent in my care · Female · 2021-11-18

Timeline

  1. 2020-12-30
    Registered in v-safe
  2. 2020-12-30
    Dose 1 — Moderna
  3. 2020-12-30
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  4. 2020-12-31
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-01-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-02
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-06
    Survey response — day 7, dose 1
    MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: Good · Site: Pain, Redness, Swelling, Itching
    Free text: Redness, swollen and itchiness on the site shot
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-01-13
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-01-20
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-01-27
    Dose 2 — Moderna
  14. 2021-01-27
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-01-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-01-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Headache, Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  17. 2021-01-30
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Itching · Headache
    Adult check-in
  18. 2021-01-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Swelling · Headache
    Adult check-in
  19. 2021-02-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  20. 2021-02-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-02-03
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-02-10
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-02-17
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-02-24
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-03
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-03-12
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-04-28
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-07-30
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-10-28
    Dose 3 — Moderna
  30. 2021-12-11
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  31. 2022-01-27
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  32. 2022-04-29
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  33. 2022-10-21
    Dose 4 — Moderna
  34. 2022-10-28
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  35. 2022-11-11
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  36. 2022-11-20
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  37. 2022-11-25
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  38. 2022-12-04
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  39. 2023-01-22
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  40. 2023-04-21
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12020-12-30Moderna
22021-01-27Moderna
32021-10-28Moderna No
42022-10-21Moderna No

Free text

Release 1 — day 7, dose 1

2021-01-06

Systemic reaction (other): Redness, swollen and itchiness on the site shot

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
SROInjection site erythema ✓ ✓ ✓
SROInjection site pruritus ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓

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

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