Y8E-49706-21476
2 vaccinations
5 coded responses
13 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 070 / NJ
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-13
Dose 1 — Moderna
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2021-01-15
Registered in v-safe
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2021-01-15
Survey response — days 1–6 daily, dose 1MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painFree text: Pain in the armpit of the shoulder I received the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Discomfort, Oedema peripheral — Feeling: Good · Site: Pain · Muscle or body achesFree text: Swollen and discomfort in armpitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Discomfort, Lymphadenopathy, Oedema peripheral, Pain in extremity — Feeling: Good · Site: Pain · Muscle or body achesFree text: Still have swelling and discomfort in armpit of arm where shot was given. Swollen lymph nodes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Discomfort, Oedema peripheral — Feeling: Good · Site: Pain · Muscle or body achesFree text: Armpit discomfort but better than yesterday. Swelling has come down.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-19
- 2021-01-20
- 2021-01-27
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2021-02-03
Survey response — day 21, dose 1MedDRA: Glossodynia, Oropharyngeal pain, Rash, Urticaria — Feeling: FairFree text: A rash from head to toe. Mostly on hands, forearms, and legs below the knee. A bit on my shoulders and on my scalp. Also sores on the tongue and sore throat. Rash was similar to hives. It lasted about 5 days before calming down.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-10
Dose 2 — Moderna
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2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-02-15
- 2021-02-24
- 2022-02-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Pain in the armpit of the shoulder I received the shot.
Systemic reaction (other): Swollen and discomfort in armpit
Systemic reaction (other): Still have swelling and discomfort in armpit of arm where shot was given. Swollen lymph nodes.
Systemic reaction (other): Armpit discomfort but better than yesterday. Swelling has come down.
Release 3 — day 21, dose 1
Symptoms: A rash from head to toe. Mostly on hands, forearms, and legs below the knee. A bit on my shoulders and on my scalp. Also sores on the tongue and sore throat. Rash was similar to hives. It lasted about 5 days before calming down.
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 | Glossodynia | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ○ | ✓ | ○ |
| SRO | Swelling | ○ | ○ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release