Y94-23447-79254
5 vaccinations
5 coded responses
54 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 441 / OH
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-11
Registered in v-safe
-
2021-02-11
Dose 1 — Moderna
- 2021-02-11
- 2021-02-12
-
2021-02-13
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising — Feeling: GoodFree text: Bruised at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-25
- 2021-03-04
-
2021-03-11
Dose 2 — Moderna
- 2021-03-11
-
2021-03-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Fatigue or tirednessAdult check-in
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
-
2021-04-01
Survey response — day 21, dose 2MedDRA: Injection site paraesthesia, Injection site pruritus, Self-medication — Feeling: GoodFree text: Alot of Itchiness and tingling radiating near shot site to shoulder; using topical creams for itchiness. No significant rash or redness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-08
Survey response — day 28, dose 2MedDRA: Paraesthesia, Pruritus — Feeling: GoodFree text: Still have tingling/itchiness on shoulder area of shot armlessening a bit since last week but still have symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-15
Survey response — day 35, dose 2MedDRA: Paraesthesia, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Still tingling on shoulder of arm received injection leads to itchinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-15
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-22
Survey response — day 42, dose 2MedDRA: Paraesthesia, Pruritus, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Still have tingling in shoulder of arm where received vaccine not as itchy as it was · Healthcare visit (other): Not new appointmentsame visit in 4/12 received hydrocortisone cream prescriptiinMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-22
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-10
- 2021-09-09
-
2021-10-22
Dose 3 — Moderna
- 2021-10-28
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2022-01-21
- 2022-02-20
-
2022-03-30
Dose 4 — Moderna
- 2022-04-23
- 2022-04-25
- 2022-04-29
- 2022-05-04
- 2022-05-11
- 2022-07-01
-
2022-09-15
Dose 5 — Moderna
- 2022-09-15
- 2022-09-16
- 2022-09-17
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-29
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-10-27
- 2022-12-15
- 2023-03-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-11 | Moderna | |
| 2 | 2021-03-11 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-03-30 | Moderna | No |
| 5 | 2022-09-15 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-15 | Unsuccessful | |
| 2021-04-22 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Bruised at injection site
Release 6 — day 21, dose 2
Symptoms: Alot of Itchiness and tingling radiating near shot site to shoulder; using topical creams for itchiness. No significant rash or redness.
Release 7 — day 28, dose 2
Symptoms: Still have tingling/itchiness on shoulder area of shot armlessening a bit since last week but still have symptoms
Release 7 — day 35, dose 2
Symptoms: Still tingling on shoulder of arm received injection leads to itchiness
Release 7 — day 42, dose 2
Symptoms: Still have tingling in shoulder of arm where received vaccine not as itchy as it was
Healthcare visit (other): Not new appointmentsame visit in 4/12 received hydrocortisone cream prescriptiin
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 |
|---|---|---|---|---|
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Injection site paraesthesia | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release