26N-23053-79472
2 vaccinations
4 coded responses
15 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 31-35
- ZIP prefix
- 431 / OH
- Registered
- 2021-04-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-10
Dose 1 — Moderna
-
2021-04-12
Registered in v-safe
-
2021-04-12
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-04-13
Survey response — days 1–6 daily, dose 1MedDRA: Weight decreased — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tirednessFree text: Lost over 5lbs of water weight at work through normal work physical activityMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
-
2021-04-15
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising — Feeling: Good · Site: PainFree text: The bruise at the injection site is much more severe than any vaccine Ive ever had before or any shot Ive ever had before. Its not a particularly bad bruise its just really bigMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
- 2021-04-17
-
2021-04-24
Survey response — day 14, dose 1MedDRA: Memory impairment, Pre-existing disease — Feeling: GoodFree text: Forgetfulness. I had this for about a month after I had COVID as well. Basically I cant remember simple things at times.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-03
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2021-05-08
Dose 2 — Moderna
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2021-05-09
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-05-12
Survey response — days 1–6 daily, dose 2MedDRA: Amnesia, Memory impairment — Feeling: Fair · Site: Pain · Headache, Diarrhea · Be unable to do your normal daily activitiesFree text: The forgetfulness has been crazy. I put the wrong shoes on for work and I have no memory of how I got to workMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-31
- 2021-06-12
- 2021-08-13
- 2021-11-09
- 2022-05-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-10 | Moderna | |
| 2 | 2021-05-08 | Moderna |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Lost over 5lbs of water weight at work through normal work physical activity
Systemic reaction (other): The bruise at the injection site is much more severe than any vaccine Ive ever had before or any shot Ive ever had before. Its not a particularly bad bruise its just really big
Release 7 — day 14, dose 1
Symptoms: Forgetfulness. I had this for about a month after I had COVID as well. Basically I cant remember simple things at times.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): The forgetfulness has been crazy. I put the wrong shoes on for work and I have no memory of how I got to work
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 | Memory impairment | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Amnesia | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Memory impairment | ✓ | ✓ | ✓ |
| SRO | Weight decreased | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release