Y4Z-10183-84495
4 vaccinations
13 coded responses
40 check-ins
13 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 100 / NY
- Registered
- 2021-02-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-13
Dose 1 — Moderna
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2021-02-15
Registered in v-safe
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2021-02-15
Survey response — days 1–6 daily, dose 1MedDRA: Injection site rash, Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Rash is on both arms; inner upper area, and adjacent area on torso. Also continued sore arm near injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-16
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Rash — Feeling: GoodFree text: Still some very light tenderness at the injection site. The rash experience early yesterday, dissipated by late evening.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-02-18
- 2021-02-19
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2021-02-20
Survey response — day 7, dose 1MedDRA: Vaccination site bruising, Vaccination site discolouration, Vaccination site induration — Feeling: GoodFree text: Its a week since I obtained the 1st dose, and a small area around the vaccination point is still black & blue and a bit hard to the touch. I noticed the bruise beginning, I believe, on day 2. It doesnt hurt but thought I mention it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
- 2021-03-06
- 2021-03-13
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2021-03-14
Dose 2 — Moderna
- 2021-03-14
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2021-03-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection siteAdult check-in
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2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection siteFree text: The rash which was on my entire upper torso, back & front, is slowly disappearing,MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Rash on torso is still evident, though much less severe than on Monday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Survey response — days 1–6 daily, dose 2MedDRA: Rash pruritic — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: After 5 days, rash is lessening, but still a bit itchy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-20
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: The rash on my torso & arms has diminished and should be gone soon.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-21
Survey response — day 7, dose 2MedDRA: Pruritus, Rash, Rash pruritic — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Rash is only slightly evident; and slightly itchy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-28
- 2021-04-04
- 2021-04-11
- 2021-04-18
- 2021-04-25
- 2021-06-13
- 2021-09-12
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2021-11-15
Dose 3 — Moderna
- 2022-03-14
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2022-07-21
Dose 4 — Moderna
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2022-07-21
Survey response — day 0, dose 4MedDRA: No adverse event — Feeling: Good · Site: RednessFree text: NoMedDRA releases: 2024-11 · check-in free text available
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2022-07-22
Survey response — days 1–6 daily, dose 4MedDRA: Injection site discomfort, Musculoskeletal stiffness — Feeling: Good · Site: PainFree text: No. The area on my arm where the injection was given is not so much painful, as the option to answer asked, it's just slightly sore and a bit stiff.MedDRA releases: 2024-11 · check-in free text available
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2022-07-23
Survey response — days 1–6 daily, dose 4MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Slight soreness in arm of injection; but less than yesterday.MedDRA releases: 2024-11 · check-in free text available
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2022-07-24
Survey response — days 1–6 daily, dose 4MedDRA: Injection site erythema, Injection site rash — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: I noticed redness around the injection site only yesterday, 2 days after receiving the injection. I previously reported there were no symptoms. I don't know why I hadn't noticed, or if the rash & redness just weren't easily visible.MedDRA releases: 2024-11 · check-in free text available
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2022-07-25
Survey response — days 1–6 daily, dose 4MedDRA: Pain in extremity, Rash — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: Rash has lessened since yesterday. Arm only slightly sore.MedDRA releases: 2024-11 · check-in free text available
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2022-07-26
Health check-in — days 1–6 daily, dose 4Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2022-07-27
- 2022-07-28
- 2022-08-04
- 2022-08-11
- 2022-08-18
- 2022-08-25
- 2022-09-01
- 2022-10-20
- 2023-01-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-14 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-07-21 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Rash is on both arms; inner upper area, and adjacent area on torso. Also continued sore arm near injection site.
Systemic reaction (other): Still some very light tenderness at the injection site. The rash experience early yesterday, dissipated by late evening.
Release 4 — day 7, dose 1
Systemic reaction (other): Its a week since I obtained the 1st dose, and a small area around the vaccination point is still black & blue and a bit hard to the touch. I noticed the bruise beginning, I believe, on day 2. It doesnt hurt but thought I mention it.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): The rash which was on my entire upper torso, back & front, is slowly disappearing,
Systemic reaction (other): Rash on torso is still evident, though much less severe than on Monday.
Systemic reaction (other): After 5 days, rash is lessening, but still a bit itchy.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): The rash on my torso & arms has diminished and should be gone soon.
Release 6 — day 7, dose 2
Systemic reaction (other): Rash is only slightly evident; and slightly itchy.
Release 12 — day 0, dose 4
Systemic reaction (other): No
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): No. The area on my arm where the injection was given is not so much painful, as the option to answer asked, it's just slightly sore and a bit stiff.
Systemic reaction (other): Slight soreness in arm of injection; but less than yesterday.
Systemic reaction (other): I noticed redness around the injection site only yesterday, 2 days after receiving the injection. I previously reported there were no symptoms. I don't know why I hadn't noticed, or if the rash & redness just weren't easily visible.
Systemic reaction (other): Rash has lessened since yesterday. Arm only slightly sore.
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 |
|---|---|---|---|---|
| SRO | Injection site discomfort | · | · | ✓ |
| SRO | Injection site erythema | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ○ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
| SRO | Vaccination site bruising | ✓ | ✓ | ✓ |
| SRO | Vaccination site discolouration | ✓ | ✓ | ✓ |
| SRO | Vaccination site induration | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release