22Z-29619-72113
2 vaccinations
7 coded responses
25 check-ins
7 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 491 / MI
- Registered
- 2021-04-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-09
Registered in v-safe
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2021-04-09
Dose 1 — Moderna
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2021-04-09
Survey response — day 0, dose 1MedDRA: Dizziness — Feeling: GoodFree text: Felt just a little light headed right after the shot but cleared up quicklyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-10
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree text: Feeling of brain fog todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-11
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal, Headache, Self-medication — Feeling: Good · Site: PainFree text: Really felt quite bad last night headache 7 or 8 on a scale of 10 and brain fog - took 400 ibuprofen and bed early felt much better today!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
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2021-04-14
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Feel good todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
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2021-04-16
Survey response — day 7, dose 1MedDRA: Headache — Feeling: Fair · HeadacheFree text: Not sure that my headache is related to the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
- 2021-04-30
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2021-05-07
Dose 2 — Moderna
- 2021-05-07
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2021-05-08
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Influenza like illness — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Just felt really tired today like I was coming down with the fluMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-10
- 2021-05-11
- 2021-05-12
- 2021-05-13
- 2021-05-14
- 2021-05-21
- 2021-05-29
- 2021-06-04
- 2021-06-11
- 2021-06-19
- 2021-08-07
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2021-11-06
Survey response — 6 months, dose 2MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Possibly more frequent headachesMedDRA releases: 2024-11 · check-in free text available
- 2022-05-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-09 | Moderna | |
| 2 | 2021-05-07 | Moderna |
Free text
Release 7 — day 0, dose 1
Systemic reaction (other): Felt just a little light headed right after the shot but cleared up quickly
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Feeling of brain fog today
Systemic reaction (other): Really felt quite bad last night headache 7 or 8 on a scale of 10 and brain fog - took 400 ibuprofen and bed early felt much better today!
Systemic reaction (other): Feel good today
Release 7 — day 7, dose 1
Systemic reaction (other): Not sure that my headache is related to the vaccine
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Just felt really tired today like I was coming down with the flu
Release 10 — 6 months, dose 2
Symptoms: Possibly more frequent headaches
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 | Headache | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Influenza like illness | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release