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Z42-69919-93213

3 vaccinations 5 coded responses 30 check-ins 5 free-text entries 2 call cases
Sex
Female
Age at first dose
41-45
ZIP prefix
180 / PA
Registered
2021-01-07
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-07
    Registered in v-safe
  2. 2021-01-07
    Dose 1 — Moderna
  3. 2021-01-07
    Health check-in — day 0, dose 1
    Feeling: Fair · Headache
    Adult check-in
  4. 2021-01-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-01-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · None
    Adult check-in
  10. 2021-01-14
    Survey response — day 7, dose 1
    MedDRA: Axillary pain, Contusion, Oedema peripheral — Feeling: Fair
    Free text: The armpit, on the arm of the injection, is bruised, swollen, and very painful
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-01-21
    Survey response — day 14, dose 1
    MedDRA: Injection site pruritus — Feeling: Good
    Free text: Itchy injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-01-28
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-04
    Dose 2 — Moderna
  14. 2021-02-04
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Itching · Nausea
    Adult check-in
  15. 2021-02-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  16. 2021-02-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  17. 2021-02-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling, Itching · None
    Adult check-in
  18. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Nausea
    Adult check-in
  19. 2021-02-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Swelling, Itching · Nausea
    Adult check-in
  20. 2021-02-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · Nausea
    Adult check-in
  21. 2021-02-11
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  22. 2021-02-18
    Survey response — day 14, dose 2
    MedDRA: Contusion, Erythema, Tenderness — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Redness, bruising on bilateral lower legs. Painful to touch
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-02-18
    Report sent to call center — day 14, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  24. 2021-08-05
    Survey response — 6 months, dose 2
    MedDRA: Hospitalisation, Rash — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization
    Free text: Developed a rash 10 days after 2nd vaccination that required hospitalization for 4 days. Treated for 30 w prednisone now gone. Md felt it was a side effect of the 2nd shot. Now have a ton of hospital bills
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  25. 2021-08-05
    Report sent to call center — 6 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    1 call case(s)
  26. 2021-08-06
  27. 2021-08-09
  28. 2021-08-12
  29. 2021-08-13
  30. 2021-08-16
  31. 2021-10-26
    Dose 3 — Moderna
  32. 2021-10-27
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  33. 2021-10-28
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymphadenopathy, Pain, Pruritus — Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness
    Free text: Swollen lymph nodes on neck and in armpit/ breast on side of injection. Painful itchy
    MedDRA releases: 2024-11 · check-in free text available
  34. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Swelling, Itching · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  35. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Itching · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  36. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  37. 2021-11-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Fatigue or tiredness, Diarrhea
    Adult check-in
  38. 2021-11-02
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  39. 2021-11-16
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-11-23
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  41. 2022-04-26
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-07Moderna
22021-02-04Moderna
32021-10-26Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-02-18 Unsuccessful
2021-08-05 Unsuccessful

Free text

Release 2 — day 7, dose 1

2021-01-14

Systemic reaction (other): The armpit, on the arm of the injection, is bruised, swollen, and very painful

Release 2 — day 14, dose 1

2021-01-21

Symptoms: Itchy injection site

Release 4 — day 14, dose 2

2021-02-18

Symptoms: Redness, bruising on bilateral lower legs. Painful to touch

Release 9 — 6 months, dose 2

2021-08-05

Symptoms: Developed a rash 10 days after 2nd vaccination that required hospitalization for 4 days. Treated for 30 w prednisone now gone. Md felt it was a side effect of the 2nd shot. Now have a ton of hospital bills

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Swollen lymph nodes on neck and in armpit/ breast on side of injection. Painful itchy

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
SDContusion ✓ ✓ ✓
SDErythema ✓ ✓ ✓
SDHospitalisation ✓ · ✓
SDInjection site pruritus ✓ ✓ ✓
SDRash ✓ · ✓
SDTenderness ✓ ✓ ✓
SROAxillary pain ✓ ✓ ✓
SROContusion ✓ ✓ ✓
SROLymphadenopathy · · ✓
SROOedema peripheral ✓ ✓ ✓
SROPain · · ✓
SROPruritus · · ✓

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