25V-17074-11879
2 vaccinations
1 coded response
3 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 342 / FL
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-19
Dose 1 — Moderna
-
2021-03-31
Registered in v-safe
-
2021-03-31
Survey response — day 7, dose 1MedDRA: Contusion, Discomfort, Headache, Immediate post-injection reaction, Lethargy — Feeling: Good · HeadacheFree text: On the initial date of my injection I felt a headache 10 minutes after the injection. My headache lasted for about two hours and felt like it was centralized in my head. The morning after my injection upon awakening I felt very lethargic and dead weight. That only was for one morning. My arm felt bruised like someone had punched it which lasted for about 2 1/2 days. Since then there have been no other symptoms to date.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-02
-
2021-04-23
Dose 2 — Moderna
-
2021-04-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness · Be unable to workAdult check-in
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-19 | Moderna | |
| 2 | 2021-04-23 | Moderna |
Free text
Release 6 — day 7, dose 1
Systemic reaction (other): On the initial date of my injection I felt a headache 10 minutes after the injection. My headache lasted for about two hours and felt like it was centralized in my head. The morning after my injection upon awakening I felt very lethargic and dead weight. That only was for one morning. My arm felt bruised like someone had punched it which lasted for about 2 1/2 days. Since then there have been no other symptoms to date.
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 | Contusion | ✓ | ✓ | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Lethargy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release