Z8G-59901-35037
5 vaccinations
5 coded responses
39 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 377 / TN
- Registered
- 2021-12-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
T86-11882-75624
Adult relative or friend · Male · 2021-12-11
Timeline
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2021-03-25
Dose 1 — Moderna
-
2021-04-26
Dose 2 — Moderna
-
2021-12-09
Dose 3 — Moderna
-
2021-12-11
Registered in v-safe
-
2021-12-11
Survey response — days 1–6 daily, dose 3MedDRA: Balance disorder, Dizziness, Ear pain, Immunisation reaction, Injection site nodule, Injection site rash, Injection site swelling, Injection site warmth, Reaction to previous exposure to any vaccine — Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tirednessFree text: Covid arm Have a rash, swelling, knot, and fever just below injection site. Same happened after second vaccine. Have also had some dizziness/equilibrium issues. Ears were hurting yesterday a lot.MedDRA releases: 2024-11 · check-in free text available
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2021-12-12
Survey response — days 1–6 daily, dose 3MedDRA: Immunisation reaction, Injection site nodule, Injection site pain, Injection site reaction, Injection site warmth, Rash pruritic — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: The Covid arm rash has grown to 4" across and top to bottom. It has a large knot under it, is very hot to the touch, and sore to the touch. It is somewhat itchy. Not located at injection site, but about 3" below.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-13
Survey response — days 1–6 daily, dose 3MedDRA: Immunisation reaction, Rash, Rash pruritic — Feeling: GoodFree text: Covid arm rash is disappearing today and very itchyMedDRA releases: 2024-11 · check-in free text available
- 2021-12-15
- 2021-12-16
- 2021-12-25
- 2022-01-01
- 2022-01-08
- 2022-01-13
- 2022-01-22
- 2022-03-11
- 2022-06-11
-
2022-07-08
Dose 4 — Moderna
-
2022-07-09
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling · Fever · Chills, HeadacheAdult check-in
-
2022-07-10
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling · HeadacheAdult check-in
- 2022-07-11
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2022-07-12
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Redness, Itching · NoneAdult check-in
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2022-07-13
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2022-07-14
- 2022-07-15
- 2022-07-22
- 2022-07-31
- 2022-08-05
- 2022-08-12
- 2022-08-21
- 2022-10-08
- 2023-01-06
-
2023-01-12
Dose 5 — Moderna
- 2023-01-13
-
2023-01-14
Survey response — days 1–6 daily, dose 5MedDRA: Immunisation reaction, Rash, Reaction to previous exposure to any vaccine — Feeling: Good · Site: Pain, Redness, Itching · Rash, not including the immediate area around the injection siteMedDRA releases: 2024-11
-
2023-01-15
Survey response — days 1–6 daily, dose 5MedDRA: Immunisation reaction — Feeling: GoodMedDRA releases: 2024-11
- 2023-01-16
- 2023-01-17
- 2023-01-18
- 2023-01-19
- 2023-01-26
- 2023-02-02
- 2023-02-09
- 2023-02-16
- 2023-02-23
- 2023-04-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-25 | Moderna | No |
| 2 | 2021-04-26 | Moderna | No |
| 3 | 2021-12-09 | Moderna | No |
| 4 | 2022-07-08 | Moderna | No |
| 5 | 2023-01-12 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Covid arm Have a rash, swelling, knot, and fever just below injection site. Same happened after second vaccine. Have also had some dizziness/equilibrium issues. Ears were hurting yesterday a lot.
Systemic reaction (other): The Covid arm rash has grown to 4" across and top to bottom. It has a large knot under it, is very hot to the touch, and sore to the touch. It is somewhat itchy. Not located at injection site, but about 3" below.
Systemic reaction (other): Covid arm rash is disappearing today and very 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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SRO | Balance disorder | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | Immunisation reaction | · | · | ✓ |
| SRO | Injection site nodule | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Injection site rash | · | · | ✓ |
| SRO | Injection site reaction | · | · | ✓ |
| SRO | Injection site swelling | · | · | ✓ |
| SRO | Injection site warmth | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Rash pruritic | · | · | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release