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ZA3-23555-07928

4 vaccinations 5 coded responses 27 check-ins 5 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
342 / FL
Registered
2021-01-30
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-29
    Dose 1 — Moderna
  2. 2021-01-30
    Registered in v-safe
  3. 2021-01-30
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-31
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site bruising, Pain in extremity — Feeling: Good · Site: Pain
    Free text: Arm became a bit sore beginning a little more than 24 hours after injection was given. Also noticed today some slight bruising around injection site.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-02-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site pain — Feeling: Good · Site: Pain
    Free text: (See above; the mild pain I developed around the injection site about 30 hrs later only lasted for about 2 days
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  8. 2021-02-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  9. 2021-02-05
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  10. 2021-02-12
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-19
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-24
    Dose 2 — Moderna
  13. 2021-02-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  14. 2021-02-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  15. 2021-02-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pruritus — Feeling: Good · Site: Itching
    Free text: a little itchy late yesterday & earlier today (although I had to get a pet scan the morning following my 2nd vaccination; so perhaps whatever all was in my system between thise 2 things possibly caused the itchiness???
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-03-03
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-03-10
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-03-17
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-24
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-31
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-07
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-26
    Survey response — 3 months, dose 2
    MedDRA: Lymphadenopathy — Feeling: Good
    Free text: enlarged lymph node(s) under my left arm shortly after vaccine. My M.D. (Oncologist) watching.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-08-25
    Survey response — 6 months, dose 2
    MedDRA: Lung neoplasm malignant, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: health condition - malignant lower left lung nodule · Healthcare visit (other): scheduled lung surgery 9/10/21
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  26. 2021-08-25
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  27. 2021-08-29
    Dose 3 — Moderna
  28. 2021-09-01
  29. 2021-11-28
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  30. 2022-02-27
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  31. 2022-04-11
    Dose 4 — Moderna
  32. 2022-04-14
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Redness · None
    Adult check-in
  33. 2022-04-15
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  34. 2022-04-17
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-29Moderna
22021-02-24Moderna
32021-08-29Moderna No
42022-04-11Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-08-25 Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): Arm became a bit sore beginning a little more than 24 hours after injection was given. Also noticed today some slight bruising around injection site.

2021-02-02

Systemic reaction (other): (See above; the mild pain I developed around the injection site about 30 hrs later only lasted for about 2 days

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): a little itchy late yesterday & earlier today (although I had to get a pet scan the morning following my 2nd vaccination; so perhaps whatever all was in my system between thise 2 things possibly caused the itchiness???

Release 8 — 3 months, dose 2

2021-05-26

Symptoms: enlarged lymph node(s) under my left arm shortly after vaccine. My M.D. (Oncologist) watching.

Release 9 — 6 months, dose 2

2021-08-25

Symptoms: health condition - malignant lower left lung nodule
Healthcare visit (other): scheduled lung surgery 9/10/21

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
HCVOUnevaluable event ✓ · ✓
SDLung neoplasm malignant ✓ · ✓
SDLymphadenopathy ✓ ✓ ✓
SROInjection site bruising ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPruritus ✓ ✓ ✓

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