2HS-28239-16883
2 vaccinations
5 coded responses
11 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 577 / SD
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-04
Dose 1 — Moderna
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2021-03-05
Registered in v-safe
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2021-03-05
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-03-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: still sore at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
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2021-03-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-10
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2021-03-11
Survey response — day 7, dose 1MedDRA: Therapeutic response unexpected — Feeling: GoodFree text: I had positive covid test in Dec. and my eyes itched and watered a lot and inside corner of left eye was always red. About 3 days after my vaccination my eyes stopped itching and watering.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — day 14, dose 1MedDRA: Abdominal discomfort, Decreased appetite, Fatigue — Feeling: FairFree text: upset stomach, no appetite, fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
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2021-04-01
Dose 2 — Moderna
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2021-09-02
Survey response — 6 months, dose 1MedDRA: Eye disorder, Eye pruritus, Headache, Lacrimation increased, Swelling of eyelid, Vein discolouration — Feeling: FairFree text: Left eye always watery and feels weird. Red veins inside corner. Looks like eye lid is closed more than right eye. Both suddenly itch and water. Random slight headaches.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2022-04-01
Survey response — 12 months, dose 2MedDRA: Cough, Fatigue — Feeling: GoodFree text: More frequent dry cough's and tired 98 o/o of the time.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | No |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): still sore at injection site
Release 5 — day 7, dose 1
Systemic reaction (other): I had positive covid test in Dec. and my eyes itched and watered a lot and inside corner of left eye was always red. About 3 days after my vaccination my eyes stopped itching and watering.
Release 5 — day 14, dose 1
Symptoms: upset stomach, no appetite, fatigue
Release 9 — 6 months, dose 1
Symptoms: Left eye always watery and feels weird. Red veins inside corner. Looks like eye lid is closed more than right eye. Both suddenly itch and water. Random slight headaches.
Release 11 — 12 months, dose 2
Symptoms: More frequent dry cough's and tired 98 o/o of the time.
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 | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Eye disorder | ✓ | · | ✓ |
| SD | Eye pruritus | ✓ | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Lacrimation increased | ✓ | · | ✓ |
| SD | Swelling of eyelid | ✓ | · | ✓ |
| SD | Vein discolouration | ✓ | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Therapeutic response unexpected | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release