2VJ-13178-76991
5 vaccinations
8 coded responses
66 check-ins
8 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 958 / CA
- Registered
- 2021-02-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-26
Dose 1 — Moderna
-
2021-02-28
Registered in v-safe
-
2021-02-28
Survey response — days 1–6 daily, dose 1MedDRA: Syncope — Feeling: Good · Site: PainFree text: 3 red lines 2 of which are faint un underside of arm where vaccination occurred more prominent one about 2 inches long not very wideMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-01
Survey response — days 1–6 daily, dose 1MedDRA: Injection site discolouration — Feeling: Good · Site: PainFree text: Same as yesterday lines under injection site arm seem to be fadingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-02
Survey response — days 1–6 daily, dose 1MedDRA: Erythema, Injection site reaction — Feeling: GoodFree text: As previously mentioned had three red lines on underside of injection site arm near armpit one has disappeared one is barely visible one is still noticeableMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Injection site erythema — Feeling: GoodFree text: As before has 3 red lines inderneath injection site arm 1 has gone 1 is barely visilble. 1 is still noticeable but faded and probably a little shorterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-04
Survey response — days 1–6 daily, dose 1MedDRA: Injection site erythema — Feeling: GoodFree text: Two of the three red lines on underside of injection site arm have faded the one left is mostly fadedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-12
- 2021-03-19
-
2021-03-26
Dose 2 — Moderna
- 2021-03-26
-
2021-03-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
-
2021-06-25
Survey response — 3 months, dose 2MedDRA: Adverse reaction — Feeling: GoodFree text: Had urinary issues tied to the use of lamisal in tje groin areaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-09-24
-
2021-10-28
Dose 3 — Moderna
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: Pain · HeadacheFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2022-01-27
-
2022-04-28
Survey response — 6 months, dose 3MedDRA: Abdominal discomfort, Constipation, Gastrointestinal disorder, Gastrointestinal sounds abnormal — Feeling: GoodFree text: Stomach issues like constipated, difestive noises and upset stomachMedDRA releases: 2024-11 · check-in free text available
-
2022-05-03
Dose 4 — Moderna
- 2022-05-03
-
2022-05-04
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2022-05-05
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-05-06
- 2022-05-07
- 2022-05-08
- 2022-05-09
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-06-14
- 2022-08-02
-
2022-10-21
Dose 5 — Moderna
- 2022-10-21
-
2022-10-22
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2022-10-23
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-10-24
- 2022-10-25
- 2022-10-26
- 2022-10-27
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-11-18
- 2022-11-25
- 2022-12-02
- 2023-01-20
- 2023-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-26 | Moderna | |
| 2 | 2021-03-26 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-05-03 | Moderna | No |
| 5 | 2022-10-21 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): 3 red lines 2 of which are faint un underside of arm where vaccination occurred more prominent one about 2 inches long not very wide
Systemic reaction (other): Same as yesterday lines under injection site arm seem to be fading
Systemic reaction (other): As previously mentioned had three red lines on underside of injection site arm near armpit one has disappeared one is barely visible one is still noticeable
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): As before has 3 red lines inderneath injection site arm 1 has gone 1 is barely visilble. 1 is still noticeable but faded and probably a little shorter
Systemic reaction (other): Two of the three red lines on underside of injection site arm have faded the one left is mostly faded
Release 9 — 3 months, dose 2
Symptoms: Had urinary issues tied to the use of lamisal in tje groin area
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): No
Release 11 — 6 months, dose 3
Symptoms: Stomach issues like constipated, difestive noises and upset stomach
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 | Adverse reaction | ✓ | ✓ | ✓ |
| SD | Constipation | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Gastrointestinal sounds abnormal | · | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Injection site discolouration | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site reaction | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release