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ZFM-81053-21942

3 vaccinations 4 coded responses 14 check-ins 4 free-text entries 0 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
916 / CA
Registered
2021-02-20
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-26
    Dose 1 — Moderna
  2. 2021-02-20
    Registered in v-safe
  3. 2021-02-20
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  4. 2021-02-23
    Dose 2 — Moderna
  5. 2021-02-23
    Survey response — day 0, dose 2
    MedDRA: Injection site pain, Medical counselling — Feeling: Good
    Free text: Injection site from first shot sore 4 wks later. Nurse today advised me to me move arm around to help prevent that from happening with second shot
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  7. 2021-02-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site urticaria — Feeling: Good · Site: Pain, Swelling, Itching
    Free text: I had hives around the site last night. Took an Allegra. Clear by the morning.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Urticaria — Feeling: Good · Site: Pain
    Free text: I had a hive on my chest last night but not sure if related to vaccine as I get hives sometimes. Resolved with antihistamine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  10. 2021-02-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-03-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease — Feeling: Fair · Site: Itching · Fatigue or tiredness, Nausea
    Free text: I also have allergies so not sure is symptoms related to vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-02
    Health check-in — day 7, dose 2
    Feeling: Good · None · Be unable to do your normal daily activities
    Adult check-in
  13. 2021-10-27
    Dose 3 — Moderna
  14. 2021-10-27
    Health check-in — day 0, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  15. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Adult check-in
  16. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  17. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  18. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-26Moderna
22021-02-23Moderna
32021-10-27Moderna No

Free text

Release 4 — day 0, dose 2

2021-02-23

Systemic reaction (other): Injection site from first shot sore 4 wks later. Nurse today advised me to me move arm around to help prevent that from happening with second shot

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): I had hives around the site last night. Took an Allegra. Clear by the morning.

2021-02-26

Systemic reaction (other): I had a hive on my chest last night but not sure if related to vaccine as I get hives sometimes. Resolved with antihistamine.

2021-03-01

Systemic reaction (other): I also have allergies so not sure is symptoms related to vaccine

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
SROInjection site pain ✓ ✓ ✓
SROInjection site urticaria ✓ ✓ ✓
SROMedical counselling ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROUrticaria ✓ ✓ ✓

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