JE2-28123-64973
3 vaccinations
1 coded response
41 check-ins
1 free-text entry
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 570 / SD
- Registered
- 2021-04-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
ZXH-31491-95424
Child or adolescent in my care · Female · 2021-12-23
Timeline
-
2021-04-19
Registered in v-safe
-
2021-04-19
Dose 1 — Moderna
-
2021-04-19
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-20
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-04-21
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
-
2021-04-22
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-04-23
- 2021-04-24
-
2021-04-25
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Chills, Headache, Fatigue or tirednessAdult check-in
- 2021-04-26
-
2021-05-03
Survey response — day 14, dose 1MedDRA: Hypersensitivity, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth — Feeling: FairFree text: Allergic reaction in arm near vaccine site: pink, hot, itchy swelling area about 4 inches in diameterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-10
-
2021-05-17
Dose 2 — Moderna
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2021-05-17
Health check-in — day 0, dose 2Feeling: Good · Site: Itching · Headache, Fatigue or tirednessAdult check-in
-
2021-05-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tirednessAdult check-in
-
2021-05-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tirednessAdult check-in
- 2021-05-20
- 2021-05-21
-
2021-05-22
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-23
- 2021-05-24
- 2021-05-31
- 2021-06-07
- 2021-06-14
- 2021-06-23
- 2021-06-28
- 2021-08-18
- 2021-11-15
-
2021-12-21
Dose 3 — Moderna
- 2021-12-21
-
2021-12-22
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-12-23
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-12-24
-
2021-12-25
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-12-26
- 2021-12-27
-
2021-12-28
Health check-in — day 7, dose 3Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Vomiting · Be unable to do your normal daily activitiesAdult check-in
- 2022-01-04
- 2022-01-13
- 2022-01-20
- 2022-01-25
- 2022-02-01
- 2022-03-22
- 2022-06-23
- 2022-12-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-19 | Moderna | |
| 2 | 2021-05-17 | Moderna | |
| 3 | 2021-12-21 | Moderna | No |
Free text
Release 8 — day 14, dose 1
Symptoms: Allergic reaction in arm near vaccine site: pink, hot, itchy swelling area about 4 inches in diameter
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 | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release