2VQ-21886-20932
4 vaccinations
7 coded responses
45 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 208 / MD
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Dose 1 — Moderna
-
2021-03-04
Registered in v-safe
-
2021-03-04
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Arm shot in is sore mostly when laying in bed.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-17
- 2021-03-24
-
2021-03-31
Dose 2 — Moderna
- 2021-03-31
-
2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Hyperhidrosis — Feeling: Fair · Site: PainFree text: PerspiringMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Arm where shot given is sore touchMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-06
- 2021-04-07
- 2021-04-14
-
2021-04-21
Survey response — day 21, dose 2MedDRA: Nausea — Feeling: FairFree text: Nauseous today but only today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-06-30
- 2021-09-29
-
2021-10-26
Dose 3 — Moderna
- 2021-10-29
- 2021-10-30
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Arm at injection point was only sore part. Each day the arm at injection point hurts lessMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
-
2022-01-27
Survey response — 3 months, dose 3MedDRA: Fall, Joint injury, Joint swelling, Physiotherapy, Tinnitus — Feeling: GoodFree text: Physical therapy for left knee after falling off ladder. Increased tetinatitus in left ear suddenly about 2.5 weeks ago maybe due to taking prescription level anti inflammatory for swelling in left knee from ladder fall recently.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-31
Dose 4 — Moderna
-
2022-04-02
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fever · Joint painsAdult check-in
-
2022-04-03
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
- 2022-04-04
- 2022-04-05
- 2022-04-06
- 2022-04-07
- 2022-04-14
- 2022-04-21
- 2022-04-28
- 2022-07-02
-
2022-10-01
Survey response — 6 months, dose 4MedDRA: Office visit, SARS-CoV-2 test negative, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Symptoms: Confirmed Covid in 8-8-2022. Tested positive for Covid until 8-21-22. Tested negative for Covid multiple times since 8-23-22 until today (10-1-22). · Healthcare visit (other): Went to my doctor officeMedDRA releases: 2024-11 · check-in free text available
-
2022-10-01
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
-
2022-10-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-31 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-03-31 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Arm shot in is sore mostly when laying in bed.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Perspiring
Systemic reaction (other): Arm where shot given is sore touch
Release 7 — day 21, dose 2
Symptoms: Nauseous today but only today.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Arm at injection point was only sore part. Each day the arm at injection point hurts less
Release 11 — 3 months, dose 3
Symptoms: Physical therapy for left knee after falling off ladder. Increased tetinatitus in left ear suddenly about 2.5 weeks ago maybe due to taking prescription level anti inflammatory for swelling in left knee from ladder fall recently.
Release 12 — 6 months, dose 4
Symptoms: Confirmed Covid in 8-8-2022. Tested positive for Covid until 8-21-22. Tested negative for Covid multiple times since 8-23-22 until today (10-1-22).
Healthcare visit (other): Went to my doctor office
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Joint injury | · | · | ✓ |
| SD | Joint swelling | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Physiotherapy | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release