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
-
2020-12-30
Dose 1 — Moderna
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2021-01-01
Registered in v-safe
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2021-01-01
Survey response — days 1–6 daily, dose 1MedDRA: Contusion, Injection site erythema — Feeling: Fair · ChillsMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-01-02
Survey response — days 1–6 daily, dose 1MedDRA: Contusion — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-01-03
Survey response — days 1–6 daily, dose 1MedDRA: Oedema peripheral, Skin discolouration — Feeling: Fair · Site: SwellingMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Contusion, Erythema, Oedema peripheral — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-01-05
Survey response — days 1–6 daily, dose 1MedDRA: Oedema peripheral, Skin discolouration — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-01-06
Survey response — 7 day, dose 1MedDRA: Oedema peripheral, Skin discolouration — Feeling: Fair · Site: SwellingMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-13
- 2021-01-21
- 2021-01-27
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2021-01-28
Dose 2 — Moderna
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2021-01-29
Survey response — days 1–6 daily, dose 2MedDRA: Injection site bruising, Skin discolouration — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-01-30
Survey response — days 1–6 daily, dose 2MedDRA: Contusion — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-01-31
Survey response — days 1–6 daily, dose 2MedDRA: Contusion — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-01
Survey response — days 1–6 daily, dose 2MedDRA: Contusion, Reaction to previous exposure to any vaccine — Feeling: Good · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-02
Survey response — days 1–6 daily, dose 2MedDRA: Contusion, Lymphadenopathy — Feeling: Good · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-03
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Site: Swelling · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
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2021-02-04
Survey response — 7 day, dose 2MedDRA: Skin discolouration — Feeling: Good · Site: Swelling · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-11
- 2021-02-18
- 2021-07-29
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2021-11-12
Dose 3 — Moderna
- 2022-01-28
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2022-05-13
Survey response — 6 month, dose 3MedDRA: Tinnitus — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-28 | Moderna | |
| 3 | 2021-11-12 | Moderna | 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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Tinnitus | · | · | ✓ |
| SRO | Contusion | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | ✓ | ✓ | ✓ |
| SRO | Skin discolouration | ✓ | ✓ | ✓ |
| SRO | Swelling | ○ | ○ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release