Z3V-69638-30116
2 vaccinations
7 coded responses
26 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 280 / NC
- Registered
- 2021-02-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-26
Registered in v-safe
-
2021-02-26
Dose 1 — Moderna
-
2021-02-26
Survey response — day 0, dose 1MedDRA: Pain in extremity — Feeling: GoodFree text: Only little soreness on vaccinated armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
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2021-02-28
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Fatigue or tiredness, Diarrhea, Abdominal painAdult check-in
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
-
2021-03-26
Dose 2 — Moderna
- 2021-03-26
-
2021-03-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fever · HeadacheAdult check-in
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2021-03-28
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Fair · HeadacheFree text: Lymph node above collarbone swollen. It is about the size of a golf ball.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-29
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy, Medical counselling — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Still swollen lymph node just about collarbone on vaccination side · Healthcare visit (other): Call to Doctor. Suggested Benadryl and ibuprofen. Contact if not change.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-29
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-30
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy, Self-medication — Feeling: GoodFree text: Lymph node above right collarbone still swollen. Still taking Benadryl and ibuprofenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Fatigue or tirednessFree text: Still swollen lymph node above right collarbone. No change since 3/28/21. Benadryl and ibuprofen suggested by doctor.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Headache, Fatigue or tirednessFree text: Still lymph node swollen above right collarbone.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Survey response — day 7, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Fatigue or tirednessFree text: Still swollen lymph node above right collarboneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-06-25
- 2021-09-24
-
2022-01-20
Call successfulDoes not wish to fill out VAERS report
- 2022-03-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-26 | Moderna | |
| 2 | 2021-03-26 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-29 | Successful 2022-01-20 |
Does not wish to fill out VAERS report |
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): Only little soreness on vaccinated arm
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Lymph node above collarbone swollen. It is about the size of a golf ball.
Systemic reaction (other): Still swollen lymph node just about collarbone on vaccination side
Healthcare visit (other): Call to Doctor. Suggested Benadryl and ibuprofen. Contact if not change.
Systemic reaction (other): Lymph node above right collarbone still swollen. Still taking Benadryl and ibuprofen
Systemic reaction (other): Still swollen lymph node above right collarbone. No change since 3/28/21. Benadryl and ibuprofen suggested by doctor.
Systemic reaction (other): Still lymph node swollen above right collarbone.
Release 6 — day 7, dose 2
Systemic reaction (other): Still swollen lymph node above right collarbone
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 | Medical counselling | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release