ZK8-62071-37186
2 vaccinations
6 coded responses
19 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 152 / PA
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-11
Registered in v-safe
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2021-02-11
Dose 1 — Moderna
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2021-02-11
Health check-in — day 0, dose 1Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesAdult check-in
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2021-02-12
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: My "rash" is around my left eye, started yesterday about 15-20mins after my shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-13
Survey response — days 1–6 daily, dose 1MedDRA: Eyelid rash — Feeling: Fair · Site: Pain, Redness, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Rash is Still around my Left EyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-14
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Good · Site: Itching · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: My rash is clearing upMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-27
- 2021-03-06
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2021-03-11
Dose 2 — Moderna
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2021-03-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-03-16
Survey response — days 1–6 daily, dose 2MedDRA: Dysgeusia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: I had my "2nd"shot on Mar 11th and since the the 13th I've had this 'black-pepper' taste in my mouth, I've brushed/ rinse my mouth out several times and it still remains.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus, Self-medication — Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesFree text: My "2nd" shot symptoms are different, I've taken Benadryl and applied cortisone and ice, the "itching" is horrible, and it's taking longer for theses Symptoms to subside. So I'm Pray this is Helpful.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — day 7, dose 2MedDRA: Injection site rash, Peripheral swelling, Pruritus — Feeling: Fair · Site: Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesFree text: Arm is slightly swollen still itching and now I have a slight rash at the injection spot..MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
- 2021-04-01
- 2021-04-10
- 2021-04-15
- 2021-04-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-11 | Moderna | |
| 2 | 2021-03-11 | Moderna |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): My "rash" is around my left eye, started yesterday about 15-20mins after my shot.
Systemic reaction (other): Rash is Still around my Left Eye
Systemic reaction (other): My rash is clearing up
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): I had my "2nd"shot on Mar 11th and since the the 13th I've had this 'black-pepper' taste in my mouth, I've brushed/ rinse my mouth out several times and it still remains.
Systemic reaction (other): My "2nd" shot symptoms are different, I've taken Benadryl and applied cortisone and ice, the "itching" is horrible, and it's taking longer for theses Symptoms to subside. So I'm Pray this is Helpful.
Release 5 — day 7, dose 2
Systemic reaction (other): Arm is slightly swollen still itching and now I have a slight rash at the injection spot..
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 | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Eyelid rash | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release