2UT-11631-30156
5 vaccinations
6 coded responses
19 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 500 / IA
- Registered
- 2020-12-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-22
Registered in v-safe
-
2020-12-22
Dose 1 — Moderna
- 2020-12-22
- 2020-12-27
- 2020-12-29
- 2021-01-05
- 2021-01-12
-
2021-01-19
Dose 2 — Moderna
-
2021-02-20
Survey response — day 28, dose 2MedDRA: Chills, Lethargy, Nasopharyngitis, Pain in extremity, Peripheral swelling — Feeling: FairFree text: I have a cold but this not related to the vaccine. With the vaccine had arm pain and swelling and 2 nights of chills and 2 days of feeling lethargic.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-23
- 2021-03-02
- 2021-04-20
- 2021-07-22
-
2021-11-09
Dose 3 — Moderna
-
2022-01-19
Survey response — 12 months, dose 2MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: GoodFree text: Colds but neg for covidMedDRA releases: 2024-11 · check-in free text available
-
2022-04-19
Dose 4 — Moderna
-
2022-04-26
Survey response — day 7, dose 4MedDRA: Vertigo — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: VertigoMedDRA releases: 2024-11 · check-in free text available
- 2022-05-04
- 2022-05-10
-
2022-05-17
Survey response — day 28, dose 4MedDRA: Cough, Fatigue, Headache, Oropharyngeal pain, Quarantine, Sneezing — Feeling: Good · Be unable to work or attend schoolFree text: Increased sneezing, cough,headaches, sore throat, occasional fatigue. No fevers and all symptoms are mild. Have been able to work in gardens and mow and help wife who is having many more symptoms. Could not work because required quarantine.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-24
-
2022-05-31
Survey response — day 42, dose 4MedDRA: Abdominal distension, Abdominal pain — Feeling: FairFree text: Abd pain and bloating; not sure of cause.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-19
Survey response — 3 months, dose 4MedDRA: Vertigo — Feeling: Good · Be unable to do your normal daily activitiesFree text: VertigoMedDRA releases: 2024-11 · check-in free text available
-
2022-09-27
Dose 5 — Pfizer-BioNTech
- 2022-10-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-22 | Moderna | |
| 2 | 2021-01-19 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
| 4 | 2022-04-19 | Moderna | No |
| 5 | 2022-09-27 | Pfizer-BioNTech | No |
Free text
Release 4 — day 28, dose 2
Symptoms: I have a cold but this not related to the vaccine. With the vaccine had arm pain and swelling and 2 nights of chills and 2 days of feeling lethargic.
Release 10 — 12 months, dose 2
Symptoms: Colds but neg for covid
Release 11 — day 7, dose 4
Systemic reaction (other): Vertigo
Release 11 — day 28, dose 4
Symptoms: Increased sneezing, cough,headaches, sore throat, occasional fatigue. No fevers and all symptoms are mild. Have been able to work in gardens and mow and help wife who is having many more symptoms. Could not work because required quarantine.
Release 11 — day 42, dose 4
Symptoms: Abd pain and bloating; not sure of cause.
Release 12 — 3 months, dose 4
Symptoms: Vertigo
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 distension | · | · | ✓ |
| SD | Abdominal pain | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Lethargy | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Quarantine | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Vertigo | · | · | ✓ |
| SRO | Vertigo | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release