2TP-16501-22550
4 vaccinations
6 coded responses
12 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 112 / NY
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
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2021-02-04
Registered in v-safe
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2021-02-04
Dose 1 — Moderna
- 2021-02-04
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2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Cough, Decreased appetite, Headache — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache · Be unable to work, Be unable to do your normal daily activitiesFree text: Headache for 3 days(worst part)-severe chills at sleep(2days)-light cough-lack of appetiteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-07
Survey response — days 1–6 daily, dose 1MedDRA: Cough, Decreased appetite, Frequent bowel movements, Headache — Feeling: Poor · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Lack of appetite, defecating more, continued headache, slight cough.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-08
Survey response — days 1–6 daily, dose 1MedDRA: Cough, Rhinorrhoea — Feeling: Good · Site: Pain, SwellingFree text: Slight cough, runny nose(a little).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
- 2021-02-10
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2021-03-04
Dose 2 — Moderna
- 2021-08-05
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2021-11-30
Dose 3 — Moderna
- 2022-02-04
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2022-06-22
Dose 4 — Moderna
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2022-06-24
Survey response — days 1–6 daily, dose 4MedDRA: Axillary pain, Dizziness, Pain in extremity, Sleep disorder — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body achesFree text: Pain underneath my left arm pit wheras, the 2nd booster was injected in my left deltoid myscle. Also, feeling lightheaded since, the injection on 6-22-22. On the even8ng after thecinjection on 6-22-22, I woke up at 3:18, 5:58am from the pain in my arMedDRA releases: 2024-11 · check-in free text available
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2022-06-25
Survey response — days 1–6 daily, dose 4MedDRA: Axillary pain — Feeling: Fair · Site: Pain, SwellingFree text: Pain underneath my left arm-pjt is improving. I NEVER had that pain with the 3 previous Moderna shots. Those 3 shots wete given to me by my (b)(6) Health clinucians. This 2nd Moderna booster was given to me by the pharmacist at WaldgreensMedDRA releases: 2024-11 · check-in free text available
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2022-06-26
Survey response — days 1–6 daily, dose 4MedDRA: Axillary pain — Feeling: Good · Site: PainFree text: Mild pain underneath my left armpit(gland?).2nd Moderna booster was taken on 6-22-22 in the left deltoid muscle.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-04 | Moderna | No |
| 3 | 2021-11-30 | Moderna | No |
| 4 | 2022-06-22 | Moderna | No |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Headache for 3 days(worst part)-severe chills at sleep(2days)-light cough-lack of appetite
Systemic reaction (other): Lack of appetite, defecating more, continued headache, slight cough.
Systemic reaction (other): Slight cough, runny nose(a little).
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Pain underneath my left arm pit wheras, the 2nd booster was injected in my left deltoid myscle. Also, feeling lightheaded since, the injection on 6-22-22. On the even8ng after thecinjection on 6-22-22, I woke up at 3:18, 5:58am from the pain in my ar cut off by CDC
Systemic reaction (other): Pain underneath my left arm-pjt is improving. I NEVER had that pain with the 3 previous Moderna shots. Those 3 shots wete given to me by my (b)(6) Health clinucians. This 2nd Moderna booster was given to me by the pharmacist at Waldgreens
redacted (b)(6)
Systemic reaction (other): Mild pain underneath my left armpit(gland?).2nd Moderna booster was taken on 6-22-22 in the left deltoid muscle.
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 | Axillary pain | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Frequent bowel movements | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release