W4J-10841-03977
4 vaccinations
5 coded responses
31 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 268 / WV
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-10
Dose 1 — Moderna
-
2021-03-17
Registered in v-safe
-
2021-03-17
Survey response — day 7, dose 1MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Redness, Swelling, ItchingFree text: Pain and swelling in underarm/lymph nodeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
- 2021-03-31
-
2021-04-07
Dose 2 — Moderna
-
2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain · FeverFree text: Swollen lymph node in armpitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-21
- 2021-04-30
- 2021-05-14
- 2021-05-19
- 2021-10-06
-
2021-10-26
Dose 3 — Moderna
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Good · Site: PainFree text: Swelling of lymph node in nearby armpitMedDRA releases: 2024-11 · check-in free text available
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Axillary mass — Feeling: GoodFree text: Small lump in armpit closest to injection siteMedDRA releases: 2024-11 · check-in free text available
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-10
- 2021-11-17
- 2021-11-25
- 2021-12-07
-
2022-01-26
Survey response — 3 months, dose 3MedDRA: Laboratory test abnormal, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Drainage runny nose, positive home testMedDRA releases: 2024-11 · check-in free text available
- 2022-04-28
-
2022-10-05
Dose 4 — Moderna
- 2022-10-26
- 2022-10-26
- 2022-11-04
- 2022-11-09
- 2022-11-16
- 2023-01-04
- 2023-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Moderna | |
| 2 | 2021-04-07 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-10-05 | Moderna | No |
Free text
Release 5 — day 7, dose 1
Systemic reaction (other): Pain and swelling in underarm/lymph node
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Swollen lymph node in armpit
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Swelling of lymph node in nearby armpit
Systemic reaction (other): Small lump in armpit closest to injection site
Release 11 — 3 months, dose 3
Symptoms: Drainage runny nose, positive home test
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 | Laboratory test abnormal | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Axillary mass | · | · | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release