ZLB-17396-55097
3 vaccinations
5 coded responses
16 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 200 / DC
- Registered
- 2021-03-09
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-09
Registered in v-safe
-
2021-03-09
Dose 1 — Moderna
-
2021-03-09
Survey response — day 0, dose 1MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-10
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Pain in extremity — Feeling: Good · Site: PainFree text: Right leg pain ,right arm no pain just sore at the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-15
- 2021-03-16
-
2021-04-06
Dose 2 — Moderna
-
2021-04-06
Survey response — day 0, dose 2MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Sore Right armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-11
- 2021-04-12
- 2021-04-15
- 2021-07-06
-
2021-10-08
Dose 3 — Moderna
-
2021-10-12
Survey response — 6 months, dose 2MedDRA: Feeling abnormal, Neck pain, Oedema peripheral, Pyrexia — Feeling: Good · Be unable to do your normal daily activitiesFree text: I had the booster last Friday in my right arm under my arm pit was alittle swollen the right side of my neck near the caroid artery was hurting i developed a fever and felt bad Saturday evening.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-29
-
2021-11-05
Survey response — day 28, dose 3MedDRA: Bone scan abnormal, Computerised tomogram abnormal, Pneumonitis — Feeling: GoodFree text: I had a ct and bone scan done last week it showed that i have a little inflamation on the rightside of my right lung just wondering was it from the maderna shoe.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-09 | Moderna | |
| 2 | 2021-04-06 | Moderna | |
| 3 | 2021-10-08 | Moderna | No |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): None
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Right leg pain ,right arm no pain just sore at the injection site
Release 7 — day 0, dose 2
Systemic reaction (other): Sore Right arm
Release 10 — 6 months, dose 2
Symptoms: I had the booster last Friday in my right arm under my arm pit was alittle swollen the right side of my neck near the caroid artery was hurting i developed a fever and felt bad Saturday evening.
Release 10 — day 28, dose 3
Symptoms: I had a ct and bone scan done last week it showed that i have a little inflamation on the rightside of my right lung just wondering was it from the maderna shoe.
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 | Bone scan abnormal | · | · | ✓ |
| SD | Computerised tomogram abnormal | · | · | ✓ |
| SD | Feeling abnormal | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Oedema peripheral | · | · | ✓ |
| SD | Pneumonitis | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release