26B-81587-32697
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 26-30
- ZIP prefix
- 210 / MD
- Registered
- 2021-03-30
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-30
Registered in v-safe
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2021-03-30
Dose 1 — Moderna
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2021-03-30
Survey response — day 0, dose 1MedDRA: Nausea — Feeling: Good · NauseaFree text: The nausea was also present before the injection and has since subsided. Its common for me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-31
Survey response — days 1–6 daily, dose 1MedDRA: Back pain, Condition aggravated — Feeling: Good · Site: Pain · Muscle or body achesFree text: Bad back pain. Had it for a while but its significantly worse than normal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
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2021-04-02
Survey response — days 1–6 daily, dose 1MedDRA: Back pain, Pre-existing disease — Feeling: Good · Muscle or body achesFree text: Back pain but that was present before the shot, however it has worsened.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-03
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-04
- 2021-04-05
- 2021-04-08
- 2021-04-13
- 2021-04-22
- 2021-04-27
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2021-05-04
Dose 2 — Moderna
- 2021-05-04
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2021-05-05
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
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2021-05-10
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-05-13
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-06-08
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2021-06-15
Survey response — day 42, dose 2MedDRA: Back pain — Feeling: GoodFree text: Little bit of pain in my back on the right in the ribs. Not worsened by breathing deep or coughing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-05
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2021-11-02
Survey response — 6 months, dose 2MedDRA: Conjunctivitis, Sinusitis — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sinus infection and Conjunctivitis both of which were treated with antibiotics and both are gone.MedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-11-03
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-30 | Moderna | |
| 2 | 2021-05-04 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 6 — day 0, dose 1
Systemic reaction (other): The nausea was also present before the injection and has since subsided. Its common for me.
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Bad back pain. Had it for a while but its significantly worse than normal.
Systemic reaction (other): Back pain but that was present before the shot, however it has worsened.
Release 9 — day 42, dose 2
Symptoms: Little bit of pain in my back on the right in the ribs. Not worsened by breathing deep or coughing.
Release 10 — 6 months, dose 2
Symptoms: Sinus infection and Conjunctivitis both of which were treated with antibiotics and both are gone.
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 | Back pain | ✓ | ✓ | ✓ |
| SD | Conjunctivitis | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release