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2TY-53687-03317

3 vaccinations 4 coded responses 38 check-ins 4 free-text entries 0 call cases
Sex
Male
Age at first dose
46-50
ZIP prefix
303 / GA
Registered
2021-03-16
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
ADA-22842-14211 Child or adolescent in my care · Female · 2021-11-05

Timeline

  1. 2021-03-15
    Dose 1 — Moderna
  2. 2021-03-16
    Registered in v-safe
  3. 2021-03-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Headache, Fatigue or tiredness
    Adult check-in
  4. 2021-03-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-03-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  6. 2021-03-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-22
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-29
    Survey response — day 14, dose 1
    MedDRA: Injection site erythema, Injection site pruritus — Feeling: Good
    Free text: Not serious- but I noticed the spot where I received the shot became red and itchy for a day or so, but I cleared up.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-06
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-04-12
    Dose 2 — Moderna
  13. 2021-04-12
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  14. 2021-04-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  15. 2021-04-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  16. 2021-04-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · None
    Adult check-in
  17. 2021-04-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-04-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Headache
    Adult check-in
  19. 2021-04-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-04-21
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-04-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-03
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-10
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-17
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-24
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-07-12
    Survey response — 3 months, dose 2
    MedDRA: Cough, Nasal congestion, Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair
    Free text: Coughing, sneezing, sore throat, significant nasal and chest congestion. started 7/5. Almost all better on 7/12, but still have some congestion.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-10-11
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-10-30
    Dose 3 — Moderna
  29. 2021-10-30
    Health check-in — day 0, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  30. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  31. 2021-11-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  32. 2021-11-02
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  33. 2021-11-04
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Headache
    Adult check-in
  34. 2021-11-05
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  35. 2021-11-06
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-11-13
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  37. 2021-11-20
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  38. 2021-11-27
    Survey response — day 28, dose 3
    MedDRA: Rash — Feeling: Good
    Free text: i doubt it is related, but I have been getting a rash on my lower leg and hands.
    MedDRA releases: 2024-11 · check-in free text available
  39. 2021-12-04
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-12-11
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  41. 2022-01-29
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  42. 2022-04-30
    Survey response — 6 months, dose 3
    MedDRA: Nasal congestion, Nasopharyngitis, Pre-existing disease, Respiratory tract congestion, SARS-CoV-2 test negative, Sneezing — Feeling: Good
    Free text: Had cold symptoms of nasal congestion, chest congestion, sneezing. Probably seasonal allergies. COVID tests were negative.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-03-15Moderna
22021-04-12Moderna
32021-10-30Moderna No

Free text

Release 6 — day 14, dose 1

2021-03-29

Symptoms: Not serious- but I noticed the spot where I received the shot became red and itchy for a day or so, but I cleared up.

Release 9 — 3 months, dose 2

2021-07-12

Symptoms: Coughing, sneezing, sore throat, significant nasal and chest congestion. started 7/5. Almost all better on 7/12, but still have some congestion.

Release 10 — day 28, dose 3

2021-11-27

Symptoms: i doubt it is related, but I have been getting a rash on my lower leg and hands.

Release 11 — 6 months, dose 3

2022-04-30

Symptoms: Had cold symptoms of nasal congestion, chest congestion, sneezing. Probably seasonal allergies. COVID tests were negative.

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

FieldPreferred term2021-092023-042024-11
SDCough ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site pruritus ✓ ✓ ✓
SDNasal congestion ✓ ✓ ✓
SDNasopharyngitis · · ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPre-existing disease · · ✓
SDRash · · ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDSARS-CoV-2 test negative · · ✓
SDSneezing · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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