QLM-61719-02915
4 vaccinations
7 coded responses
34 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 752 / TX
- Registered
- 2020-12-26
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Hispanic or Latino
Registered dependents
Q55-17744-19940
Child or adolescent in my care · Female · 2022-06-21
Timeline
-
2020-12-26
Registered in v-safe
-
2020-12-26
Dose 1 — Moderna
- 2020-12-26
- 2020-12-27
-
2020-12-30
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising — Feeling: Good · Site: PainFree text: Bruising at site of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2020-12-31
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising — Feeling: Good · Site: PainFree text: Bruising at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-01
Survey response — days 1–6 daily, dose 1MedDRA: Axillary pain, Injection site bruising, Lymph node pain — Feeling: Good · Site: PainFree text: Bruising at the site of the injection and a tender lymph node in the axilla on that side as wellMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-02
Survey response — day 7, dose 1MedDRA: Injection site bruising, Lymph node pain — Feeling: Good · Site: PainFree text: Bruising at site of injection and tender lymph node in axilla on same side as injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-09
- 2021-01-16
-
2021-01-23
Dose 2 — Moderna
- 2021-01-30
- 2021-02-06
- 2021-02-13
- 2021-02-20
- 2021-02-27
- 2021-03-06
- 2021-04-24
- 2021-07-24
-
2021-10-23
Dose 3 — Moderna
- 2021-10-23
-
2021-10-24
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tirednessAdult check-in
- 2021-10-26
- 2021-10-28
- 2021-10-29
- 2021-11-01
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2022-01-22
- 2022-04-23
-
2022-09-09
Dose 4 — Moderna
-
2022-10-08
Survey response — day 28, dose 4MedDRA: Respiratory syncytial virus infection — Feeling: GoodFree text: Symptoms from RSVMedDRA releases: 2024-11 · check-in free text available
-
2022-10-16
Survey response — day 35, dose 4MedDRA: Respiratory syncytial virus infection — Feeling: FairFree text: RSVMedDRA releases: 2024-11 · check-in free text available
- 2022-10-21
- 2022-12-09
-
2023-03-12
Survey response — 6 months, dose 4MedDRA: COVID-19, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend schoolMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-26 | Moderna | |
| 2 | 2021-01-23 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-09-09 | Moderna | No |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Bruising at site of injection
Systemic reaction (other): Bruising at injection site
Systemic reaction (other): Bruising at the site of the injection and a tender lymph node in the axilla on that side as well
Release 1 — day 7, dose 1
Systemic reaction (other): Bruising at site of injection and tender lymph node in axilla on same side as injection
Release 12 — day 28, dose 4
Symptoms: Symptoms from RSV
Release 12 — day 35, dose 4
Symptoms: RSV
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 | COVID-19 | · | · | ✓ |
| SD | Respiratory syncytial virus infection | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ○ | ○ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release