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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

  1. 2021-01-13
    Dose 1 — Moderna
  2. 2021-01-15
    Registered in v-safe
  3. 2021-01-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain
    Free 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
  4. 2021-01-16
    Survey response — days 1–6 daily, dose 1
    MedDRA: Discomfort, Oedema peripheral — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: Swollen and discomfort in armpit
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Discomfort, Lymphadenopathy, Oedema peripheral, Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches
    Free 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
  6. 2021-01-18
    Survey response — days 1–6 daily, dose 1
    MedDRA: Discomfort, Oedema peripheral — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: Armpit discomfort but better than yesterday. Swelling has come down.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-20
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-27
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-03
    Survey response — day 21, dose 1
    MedDRA: Glossodynia, Oropharyngeal pain, Rash, Urticaria — Feeling: Fair
    Free 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
  11. 2021-02-10
    Dose 2 — Moderna
  12. 2021-02-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  13. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea
    Adult check-in
  14. 2021-02-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  15. 2021-02-24
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  16. 2022-02-10
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-13Moderna
22021-02-10Moderna

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Pain in the armpit of the shoulder I received the shot.

2021-01-16

Systemic reaction (other): Swollen and discomfort in armpit

2021-01-17

Systemic reaction (other): Still have swelling and discomfort in armpit of arm where shot was given. Swollen lymph nodes.

2021-01-18

Systemic reaction (other): Armpit discomfort but better than yesterday. Swelling has come down.

Release 3 — day 21, dose 1

2021-02-03

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

FieldPreferred term2021-092023-042024-11
SDGlossodynia ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDUrticaria ✓ ✓ ✓
SROAxillary pain ✓ ✓ ✓
SRODiscomfort ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROOedema peripheral ✓ ✓ ✓
SROPain in extremity ○ ✓ ○
SROSwelling ○ ○ ○

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