Z56-28852-14042
5 vaccinations
11 coded responses
28 check-ins
10 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 277 / NC
- Registered
- 2021-04-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-18
Dose 1 — Moderna
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2021-04-15
Dose 2 — Moderna
-
2021-04-18
Registered in v-safe
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2021-04-18
Survey response — days 1–6 daily, dose 2MedDRA: Injection site discolouration, Injection site pruritus, Injection site rash — Feeling: GoodFree text: Injection site is small, round and dark (there was blood there after the injection). Rash is below injection site and itches (just annoying, distracting).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pruritus, Injection site rash, Rash, Self-medication — Feeling: GoodFree text: Rash is still visible below injection site; itching has been relieved somewhat by a topical anti-itch cream rubbed into the rash site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema, Rash, Rash erythematous, Rash pruritic — Feeling: GoodFree text: Rash itching a bit less today; have applied a topical anti-itch cream. Still redness at rash site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-21
Survey response — days 1–6 daily, dose 2MedDRA: Rash, Rash erythematous, Rash pruritic — Feeling: GoodFree text: Rash below the vaccination site is less itchy today. A good sign that its going away. Rash site also much less red. Im good.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-22
Survey response — day 7, dose 2MedDRA: Pruritus, Rash erythematous — Feeling: GoodFree text: Rash redness has lessened, no itching today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
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2021-07-15
Survey response — 3 months, dose 2MedDRA: Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: UTIMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-07-15
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-23
- 2021-10-14
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2021-11-29
Dose 3 — Moderna
- 2022-04-15
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2022-06-18
Dose 4 — Moderna
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2022-06-18
Survey response — day 0, dose 4MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
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2022-06-19
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Chills, Diarrhea, Abdominal pain · Be unable to work or attend schoolAdult check-in
- 2022-06-20
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2022-06-21
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-06-22
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue — Feeling: Fair · Fatigue or tirednessFree text: Fatigue is less.MedDRA releases: 2024-11 · check-in free text available
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2022-06-23
Survey response — days 1–6 daily, dose 4MedDRA: Asthenia, Fatigue — Feeling: Fair · Fatigue or tirednessFree text: Slight tiredness; just not my usual energy.MedDRA releases: 2024-11 · check-in free text available
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2022-06-24
Survey response — days 1–6 daily, dose 4MedDRA: Adverse reaction — Feeling: GoodFree text: Feeling much better than earlier in week.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-27
- 2022-07-02
- 2022-07-09
- 2022-07-16
- 2022-08-01
- 2022-09-18
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2022-10-06
Dose 5 — Moderna
- 2023-01-07
- 2023-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-15 | Moderna | |
| 3 | 2021-11-29 | Moderna | No |
| 4 | 2022-06-18 | Moderna | No |
| 5 | 2022-10-06 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-15 | Unsuccessful |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Injection site is small, round and dark (there was blood there after the injection). Rash is below injection site and itches (just annoying, distracting).
Systemic reaction (other): Rash is still visible below injection site; itching has been relieved somewhat by a topical anti-itch cream rubbed into the rash site.
Systemic reaction (other): Rash itching a bit less today; have applied a topical anti-itch cream. Still redness at rash site.
Systemic reaction (other): Rash below the vaccination site is less itchy today. A good sign that its going away. Rash site also much less red. Im good.
Release 7 — day 7, dose 2
Systemic reaction (other): Rash redness has lessened, no itching today.
Release 9 — 3 months, dose 2
Symptoms: UTI
Release 12 — day 0, dose 4
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Fatigue is less.
Systemic reaction (other): Slight tiredness; just not my usual energy.
Systemic reaction (other): Feeling much better than earlier in week.
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 | Hordeolum | · | · | ✓ |
| SD | Urinary tract infection | ✓ | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Asthenia | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Injection site discolouration | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash erythematous | ✓ | ✓ | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
| SRO | Self-medication | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release