Z22-82916-65304
5 vaccinations
4 coded responses
35 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 605 / IL
- Registered
- 2021-04-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-05
Dose 1 — Moderna
-
2021-04-02
Registered in v-safe
-
2021-04-02
Dose 2 — Moderna
-
2021-04-02
Survey response — day 0, dose 2MedDRA: Breast tenderness — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesFree text: Breast tenderness on right breastMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Rt breast sentinel lymph nodes swollen including tenderness and pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
-
2021-04-09
Survey response — day 7, dose 2MedDRA: Dizziness — Feeling: GoodFree text: Actually on & off light headed and dizziness since 1st and second vaccination but it's intermittent. I hadn't previously mentioned it other than the initial day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-07-02
- 2021-10-01
-
2021-11-09
Dose 3 — Moderna
- 2022-04-02
-
2022-05-09
Dose 4 — Moderna
- 2022-05-09
-
2022-05-10
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-05-11
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-05-12
- 2022-05-13
- 2022-05-14
- 2022-05-15
- 2022-05-16
- 2022-05-23
- 2022-05-30
- 2022-06-07
- 2022-06-14
- 2022-06-20
- 2022-08-08
-
2022-09-09
Dose 5 — ModernaCo-administered: Flu
-
2022-10-12
Survey response — day 28, dose 5MedDRA: Influenza like illness, Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: Good · Be unable to do your normal daily activitiesFree text: After receiving 5th Moderna bivalent and flu vaccine i experienced moderate to severe flu-like symtoms and severe swelling, redness and itching at injection sites. Covid vaccine symptoms of redness, swelling and itching lasted 2 weeks. Flu 3 weeks.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-14
- 2022-10-21
- 2022-12-09
- 2023-03-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
| 4 | 2022-05-09 | Moderna | No |
| 5 | 2022-09-09 | Moderna | Flu |
Free text
Release 6 — day 0, dose 2
Systemic reaction (other): Breast tenderness on right breast
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Rt breast sentinel lymph nodes swollen including tenderness and pain.
Release 7 — day 7, dose 2
Systemic reaction (other): Actually on & off light headed and dizziness since 1st and second vaccination but it's intermittent. I hadn't previously mentioned it other than the initial day.
Release 12 — day 28, dose 5
Symptoms: After receiving 5th Moderna bivalent and flu vaccine i experienced moderate to severe flu-like symtoms and severe swelling, redness and itching at injection sites. Covid vaccine symptoms of redness, swelling and itching lasted 2 weeks. Flu 3 weeks. cut off by CDC
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 | Influenza like illness | · | · | ✓ |
| SD | Injection site erythema | · | · | ✓ |
| SD | Injection site pruritus | · | · | ✓ |
| SD | Injection site swelling | · | · | ✓ |
| SRO | Breast tenderness | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release