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XZG-38993-63791

3 vaccinations 14 coded responses 21 check-ins 14 free-text entries 0 call cases
Sex
Female
Age at first dose
41-45
ZIP prefix
693 / NE
Registered
2021-01-01
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2020-12-30
    Dose 1 — Moderna
  2. 2021-01-01
    Registered in v-safe
  3. 2021-01-01
    Survey response — days 1–6 daily, dose 1
    MedDRA: Contusion, Injection site erythema — Feeling: Fair · Chills
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  4. 2021-01-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Contusion — Feeling: Good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  5. 2021-01-03
    Survey response — days 1–6 daily, dose 1
    MedDRA: Oedema peripheral, Skin discolouration — Feeling: Fair · Site: Swelling
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  6. 2021-01-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Contusion, Erythema, Oedema peripheral — Feeling: Good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  7. 2021-01-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: Oedema peripheral, Skin discolouration — Feeling: Good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  8. 2021-01-06
    Survey response — 7 day, dose 1
    MedDRA: Oedema peripheral, Skin discolouration — Feeling: Fair · Site: Swelling
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  9. 2021-01-13
    Health check-in — 14 day, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-01-21
    Health check-in — 21 day, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-01-27
    Health check-in — 28 day, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-01-28
    Dose 2 — Moderna
  13. 2021-01-29
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site bruising, Skin discolouration — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  14. 2021-01-30
    Survey response — days 1–6 daily, dose 2
    MedDRA: Contusion — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  15. 2021-01-31
    Survey response — days 1–6 daily, dose 2
    MedDRA: Contusion — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  16. 2021-02-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Contusion, Reaction to previous exposure to any vaccine — Feeling: Good · Rash, not including the immediate area around the injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  17. 2021-02-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Contusion, Lymphadenopathy — Feeling: Good · Rash, not including the immediate area around the injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  18. 2021-02-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymphadenopathy — Feeling: Good · Site: Swelling · Rash, not including the immediate area around the injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  19. 2021-02-04
    Survey response — 7 day, dose 2
    MedDRA: Skin discolouration — Feeling: Good · Site: Swelling · Rash, not including the immediate area around the injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  20. 2021-02-11
    Health check-in — 14 day, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-02-18
    Health check-in — 21 day, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-07-29
    Health check-in — 6 month, dose 2
    Feeling: Fair
    Adult check-in
  23. 2021-11-12
    Dose 3 — Moderna
  24. 2022-01-28
    Health check-in — 12 month, dose 2
    Feeling: Good
    Adult check-in
  25. 2022-05-13
    Survey response — 6 month, dose 3
    MedDRA: Tinnitus — Feeling: Good
    MedDRA releases: 2024-11 · check-in answers available

Vaccinations

DoseDateManufacturerCo-administered
12020-12-30Moderna
22021-01-28Moderna
32021-11-12Moderna No

Free text

Release 1

Systemic reaction (other): Left Axillary Region was notable discolored(Bruise coloration) greater than 10 cm in length at 48 hours post immunization. Actual injection site: no reaction, 2 inches below erythema present.

Systemic reaction (other): Left Axillary Bruised region is beginning to lighten in color.

Systemic reaction (other): Swelling to Left Axillary area, same arm as injection site. Visible discoloration greater than 10 cm present.

Systemic reaction (other): Left Axillary Region remains swollen and red/ purple bruise appearance area greater than 10cm remains, bruise appearance in the left Axillary region remains present.

Systemic reaction (other): Left Axillary region not as dark as before, remains slightly swollen.

Systemic reaction (other): Continued swelling on Left Axillary Area( Left Arm was used for inoculation). Discoloration is fading out a bit today, outline is still visible.

Release 3

Systemic reaction (other): Left Axillary darkened region returned, identical to Reaction noted post 1st injection. Affected area appears as bruise in color.Experienced Insomnia post 2nd injection. .

Systemic reaction (other): Left Axillary Region greater than 10 cm, marquise shape. Bruised appearance. Shape is the exact same as post 1st injection.

Systemic reaction (other): Left Axillary area bruised, greater than 10 cm .

Systemic reaction (other): Left Axillary site remains bruised in appearance. Same shape as post First injection. Greater than 10 cm in size.

Systemic reaction (other): Left axillary region bruised in appearance same experience as post first injection.

Systemic reaction (other): Left Axillary site remains reddened, swelling to left Axillary lymph nodes.

Systemic reaction (other): Left Axillary site remains discolored, beginning to fade.

Release 11

Symptoms: Occasional/ short lasting tinnitus

Free-text releases are not linked to a specific 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
SDTinnitus · · ✓
SROContusion ✓ ✓ ✓
SROErythema ✓ ✓ ✓
SROInjection site bruising ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROOedema peripheral ✓ ✓ ✓
SROReaction to previous exposure to any vaccine ✓ ✓ ✓
SROSkin discolouration ✓ ✓ ✓
SROSwelling ○ ○ ○

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