QSZ-16895-71054
3 vaccinations
3 coded responses
28 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 229 / VA
- Registered
- 2021-02-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-15
Registered in v-safe
-
2021-02-15
Dose 1 — Moderna
- 2021-02-15
-
2021-02-16
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-02-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-02-18
- 2021-02-19
- 2021-02-20
-
2021-02-21
Survey response — days 1–6 daily, dose 1MedDRA: Axillary pain — Feeling: Good · Site: Pain, SwellingFree text: My glands in my armpit on injection side are very painfulMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-22
Survey response — day 7, dose 1MedDRA: Fatigue, Injection site pain, Injection site pruritus, Injection site rash, Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tirednessFree text: Today I developed a itch rash and burning around the injection site. About 3 inches in diameter. I feel very tired and my glands are swollen in that underarmMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-08
-
2021-03-15
Dose 2 — Moderna
- 2021-03-15
-
2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
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2021-03-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-03-20
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body achesAdult check-in
- 2021-03-21
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-06-14
- 2021-09-13
-
2022-01-29
Dose 3 — Moderna
- 2022-03-15
- 2022-04-30
-
2022-07-30
Survey response — 6 months, dose 3MedDRA: Amnesia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Memory lossMedDRA releases: 2024-11 · check-in free text available
-
2022-07-30
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-08-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-01-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-15 | Moderna | |
| 2 | 2021-03-15 | Moderna | |
| 3 | 2022-01-29 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): My glands in my armpit on injection side are very painful
Release 4 — day 7, dose 1
Systemic reaction (other): Today I developed a itch rash and burning around the injection site. About 3 inches in diameter. I feel very tired and my glands are swollen in that underarm
Release 12 — 6 months, dose 3
Symptoms: Memory loss
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 | Amnesia | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release