256-19751-49915
4 vaccinations
3 coded responses
46 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 856 / AZ
- Registered
- 2021-02-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-04
Dose 1 — Moderna
-
2021-02-14
Registered in v-safe
- 2021-02-25
- 2021-03-06
-
2021-03-11
Dose 2 — Moderna
-
2021-03-11
Survey response — day 0, dose 2MedDRA: Unevaluable event — Feeling: Good · FeverFree text: The gi track has taken a turn around to my younger days that I remember as normal. At first or about a week after the first shot things began to change and as each week has gone by the improvement has been remarkable and life is , as they , life is but a dream ,and tomorrow I feel like washing windows or some other wild and crazy thing. I am 86 still able to get around and do things and the only thing that hasnt happened, now what did you say your name was? I think that will happen and I look forward to it. Theres more but I can talk better than this tap tap stuff.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Survey response — days 1–6 daily, dose 2MedDRA: Gastrointestinal disorder — Feeling: Good · Site: ItchingFree text: I would like to talk someone about the GI involvement if they are interested?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
- 2021-04-03
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-06-10
-
2021-10-26
Dose 3 — Moderna
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Dizziness — Feeling: Fair · Headache, NauseaFree text: DizzyMedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2022-01-25
- 2022-04-26
-
2022-05-03
Dose 4 — Moderna
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-08
- 2022-05-09
- 2022-05-11
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-06-14
- 2022-08-02
- 2022-11-02
- 2023-05-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-11 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-05-03 | Moderna | No |
Free text
Release 5 — day 0, dose 2
Systemic reaction (other): The gi track has taken a turn around to my younger days that I remember as normal. At first or about a week after the first shot things began to change and as each week has gone by the improvement has been remarkable and life is , as they , life is but a dream ,and tomorrow I feel like washing windows or some other wild and crazy thing. I am 86 still able to get around and do things and the only thing that hasnt happened, now what did you say your name was? I think that will happen and I look forward to it. Theres more but I can talk better than this tap tap stuff.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): I would like to talk someone about the GI involvement if they are interested?
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Dizzy
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 | Dizziness | · | · | ✓ |
| SRO | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release