2X5-32617-77297
5 vaccinations
6 coded responses
41 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 995 / AK
- Registered
- 2021-10-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-25
Dose 1 — Moderna
-
2021-04-22
Dose 2 — Moderna
-
2021-10-26
Registered in v-safe
-
2021-10-26
Dose 3 — Moderna
-
2021-10-26
Survey response — day 0, dose 3MedDRA: Brain fog, Immediate post-injection reaction, Sensory disturbance — Feeling: Good · Fatigue or tirednessFree text: 45 minutes after the shot, I have a total body sensation and I can feel that I have been injected with something. I am not as clear headed as I was prior to the shot.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-09
- 2021-11-16
- 2021-11-23
-
2021-11-30
Survey response — day 35, dose 3MedDRA: Headache, Pain, Respiratory tract congestion — Feeling: FairFree text: Headache, body ache, head congestionMedDRA releases: 2024-11 · check-in free text available
- 2021-12-07
-
2022-01-25
Survey response — 3 months, dose 3MedDRA: Gastrointestinal disorder — Feeling: GoodFree text: Intestinal. Getting CT scanMedDRA releases: 2024-11 · check-in free text available
-
2022-04-21
Dose 4 — Moderna
- 2022-04-21
-
2022-04-22
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness · Fatigue or tirednessAdult check-in
-
2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-04-27
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-19
- 2022-05-26
- 2022-06-02
- 2022-07-21
-
2022-10-06
Dose 5 — Moderna
- 2022-10-06
- 2022-10-07
-
2022-10-09
Survey response — days 1–6 daily, dose 5MedDRA: Arthralgia — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tirednessFree text: Severe joint pain in both handsMedDRA releases: 2024-11 · check-in free text available
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2022-10-11
Health check-in — days 1–6 daily, dose 5Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2022-10-12
- 2022-10-13
-
2022-10-21
Survey response — day 14, dose 5MedDRA: Fatigue — Feeling: GoodFree text: Still tired more often than usual. There is a question you have about activity level such as being unable to work. I persevere regardless so my answers most likely does not reflect good dataMedDRA releases: 2024-11 · check-in free text available
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-11-17
- 2023-01-05
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2023-04-06
Survey response — 6 months, dose 5MedDRA: Office visit, Poor peripheral circulation — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
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2023-04-06
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professional1 call case(s)
- 2023-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-25 | Moderna | No |
| 2 | 2021-04-22 | Moderna | No |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-04-21 | Moderna | No |
| 5 | 2022-10-06 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 10 — day 0, dose 3
Systemic reaction (other): 45 minutes after the shot, I have a total body sensation and I can feel that I have been injected with something. I am not as clear headed as I was prior to the shot.
Release 10 — day 35, dose 3
Symptoms: Headache, body ache, head congestion
Release 11 — 3 months, dose 3
Symptoms: Intestinal. Getting CT scan
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Severe joint pain in both hands
Release 12 — day 14, dose 5
Symptoms: Still tired more often than usual. There is a question you have about activity level such as being unable to work. I persevere regardless so my answers most likely does not reflect good data
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 | Fatigue | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Poor peripheral circulation | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Immediate post-injection reaction | · | · | ✓ |
| SRO | Sensory disturbance | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release