2WX-71694-05469
5 vaccinations
5 coded responses
55 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 852 / AZ
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Registered in v-safe
-
2021-01-28
Dose 1 — Moderna
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
-
2021-02-11
Survey response — day 14, dose 1MedDRA: Erythema, Induration, Injection site pruritus, Skin warm, Tenderness — Feeling: GoodFree text: On February the 6th or February the 7th I developed a red patch and itching at the injection site. The itching has subsided somewhat now. The red area has gotten larger and more uniform. The red area is somewhat warm & sore to the touch & firm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
-
2021-02-25
Dose 2 — Moderna
- 2021-02-25
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Fatigue or tirednessAdult check-in
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · Fatigue or tirednessAdult check-in
-
2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-05-27
- 2021-08-28
-
2021-09-09
Dose 3 — Moderna
- 2021-10-25
- 2021-12-09
- 2022-03-10
-
2022-05-11
Dose 4 — Moderna
- 2022-05-11
- 2022-05-12
- 2022-05-13
- 2022-05-14
- 2022-05-15
- 2022-05-16
- 2022-05-17
- 2022-05-18
-
2022-05-25
Survey response — day 14, dose 4MedDRA: Paranasal sinus discomfort, Sinus headache — Feeling: FairFree text: Sinus pressure and headacheMedDRA releases: 2024-11 · check-in free text available
- 2022-06-01
- 2022-06-08
- 2022-06-15
- 2022-06-22
- 2022-08-10
-
2022-09-07
Dose 5 — Moderna
- 2022-09-07
- 2022-09-08
- 2022-09-09
- 2022-09-10
- 2022-09-11
- 2022-09-19
- 2022-09-21
- 2022-09-28
-
2022-10-05
Survey response — day 28, dose 5MedDRA: Chills, Diarrhoea, Pyrexia — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Three days ago I came down with a fever and chills and diarrhea.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-12
- 2022-10-19
-
2022-12-07
Survey response — 3 months, dose 5MedDRA: Malaise, Pyrexia — Feeling: GoodFree text: Approximately 30 days ago I had a low grade fever for a couple of days and just didn't feel particularly well. I took a rapid antigen test which tested negative. No symptoms of a cold or congestion or any other issues.MedDRA releases: 2024-11 · check-in free text available
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2023-03-08
Survey response — 6 months, dose 5MedDRA: Coronary artery disease — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-25 | Moderna | |
| 3 | 2021-09-09 | Moderna | No |
| 4 | 2022-05-11 | Moderna | No |
| 5 | 2022-09-07 | Moderna | No |
Free text
Release 4 — day 14, dose 1
Symptoms: On February the 6th or February the 7th I developed a red patch and itching at the injection site. The itching has subsided somewhat now. The red area has gotten larger and more uniform. The red area is somewhat warm & sore to the touch & firm.
Release 11 — day 14, dose 4
Symptoms: Sinus pressure and headache
Release 12 — day 28, dose 5
Symptoms: Three days ago I came down with a fever and chills and diarrhea.
Release 12 — 3 months, dose 5
Symptoms: Approximately 30 days ago I had a low grade fever for a couple of days and just didn't feel particularly well. I took a rapid antigen test which tested negative. No symptoms of a cold or congestion or any other issues.
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 | Chills | · | · | ✓ |
| SD | Coronary artery disease | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Induration | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Sinus headache | · | · | ✓ |
| SD | Skin warm | ✓ | ✓ | ✓ |
| SD | Tenderness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release