Y6W-42074-81993
4 vaccinations
7 coded responses
51 check-ins
7 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 957 / CA
- Registered
- 2021-03-21
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-20
Dose 1 — Moderna
-
2021-03-21
Registered in v-safe
-
2021-03-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Joint pains, Fatigue or tirednessAdult check-in
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-04-03
- 2021-04-10
-
2021-04-17
Dose 2 — Moderna
-
2021-04-17
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-18
- 2021-04-19
-
2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Rash, Rash pruritic, Urticaria — Feeling: Fair · Chills, Headache · Be unable to do your normal daily activitiesFree text: Hive like bumps on both lower legs causing constant itchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-21
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus, Rash, Urticaria — Feeling: Fair · Rash, not including the immediate area around the injection siteFree text: Hive like rash on both legs with constant itchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus, Urticaria — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Hive like rash on both legs that constantly itches.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
- 2021-05-01
- 2021-05-08
- 2021-05-15
- 2021-05-22
- 2021-05-29
- 2021-07-17
- 2021-10-16
-
2021-10-28
Dose 3 — Moderna
-
2021-10-28
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-29
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2022-01-27
-
2022-04-15
Dose 4 — Pfizer-BioNTech
-
2022-04-15
Survey response — day 0, dose 4MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Sore armMedDRA releases: 2024-11 · check-in free text available
-
2022-04-16
Survey response — days 1–6 daily, dose 4MedDRA: Joint swelling, Peripheral swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Swollen feet, ankles and shoulder around injection site.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-17
Survey response — days 1–6 daily, dose 4MedDRA: Joint swelling, Peripheral swelling — Feeling: Good · Site: Swelling, ItchingFree text: Mild swelling in ankles and feetMedDRA releases: 2024-11 · check-in free text available
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-22
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
-
2022-05-28
Survey response — day 42, dose 4MedDRA: Peripheral swelling, Quality of life decreased — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Swelling in both feet for approximately the past 4-5 weeks which has gotten progressively worse to the point where it's affecting my quality of life. I'm unsure if this is related to the Covid vaccination.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-15
- 2023-04-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-20 | Moderna | |
| 2 | 2021-04-17 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-04-15 | Pfizer-BioNTech | No |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Hive like bumps on both lower legs causing constant itching
Systemic reaction (other): Hive like rash on both legs with constant itching
Systemic reaction (other): Hive like rash on both legs that constantly itches.
Release 11 — day 0, dose 4
Systemic reaction (other): Sore arm
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Swollen feet, ankles and shoulder around injection site.
Systemic reaction (other): Mild swelling in ankles and feet
Release 11 — day 42, dose 4
Symptoms: Swelling in both feet for approximately the past 4-5 weeks which has gotten progressively worse to the point where it's affecting my quality of life. I'm unsure if this is related to the Covid vaccination.
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 | Peripheral swelling | · | · | ✓ |
| SD | Quality of life decreased | · | · | ✓ |
| SRO | Joint swelling | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Peripheral swelling | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
| SRO | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release