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33S-16485-55008

2 vaccinations 6 coded responses 24 check-ins 6 free-text entries 0 call cases
Sex
Male
Age at first dose
41-45
ZIP prefix
105 / NY
Registered
2021-01-02
Relationship
Self
Race
White
Ethnicity
N/A

Timeline

  1. 2021-01-02
    Registered in v-safe
  2. 2021-01-02
    Dose 1 — Moderna
  3. 2021-01-02
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Fever · None
    Adult check-in
  5. 2021-01-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-09
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-16
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-01-23
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-01-30
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-03
    Dose 2 — Moderna
  14. 2021-02-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  15. 2021-02-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Body temperature increased, Self-medication, Unevaluable event — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: I had a fever of 100.0 last night after my survey. Controlled with Tylenol
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Muscle or body aches
    Adult check-in
  17. 2021-02-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site discolouration — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches
    Free text: Discoloration at injection sight noticed last night
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-02-10
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-02-19
    Survey response — day 14, dose 2
    MedDRA: Dizziness, Fatigue, Injection site pain, Taste disorder — Feeling: Good
    Free text: Pain at injection site on Monday and Tuesday 5-6/10. Had extreme fatigue Sunday-Wednesday with some dizziness. Noticed change in taste. No change to smell.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-02-25
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-04
    Survey response — day 28, dose 2
    MedDRA: Dysgeusia — Feeling: Good
    Free text: My taste has been off.. decreased and having a metallic taste intermittently
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-03-10
    Survey response — day 35, dose 2
    MedDRA: Ageusia, Dysgeusia — Feeling: Good
    Free text: My taste is off.. having metallic taste on and off. Slight decrease in taste. Smell not effected at all
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-03-19
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-05
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-08-04
    Survey response — 6 months, dose 2
    MedDRA: Arthralgia, Blood glucose fluctuation, Blood glucose increased, Fatigue, Pain, Vaccination site pain — Feeling: Fair
    Free text: Vaccine shot site hurting 8/10. The entire left shoulder. Feeling really tired and sore on and off. Glucose levels have been running higher than normal and fluctuating drastically. Was well controlled before vaccine.
    MedDRA releases: 2021-09,2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-02Moderna
22021-02-03Moderna

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): I had a fever of 100.0 last night after my survey. Controlled with Tylenol

2021-02-07

Systemic reaction (other): Discoloration at injection sight noticed last night

Release 4 — day 14, dose 2

2021-02-19

Symptoms: Pain at injection site on Monday and Tuesday 5-6/10. Had extreme fatigue Sunday-Wednesday with some dizziness. Noticed change in taste. No change to smell.

Release 5 — day 28, dose 2

2021-03-04

Symptoms: My taste has been off.. decreased and having a metallic taste intermittently

Release 5 — day 35, dose 2

2021-03-10

Symptoms: My taste is off.. having metallic taste on and off. Slight decrease in taste. Smell not effected at all

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: Vaccine shot site hurting 8/10. The entire left shoulder. Feeling really tired and sore on and off. Glucose levels have been running higher than normal and fluctuating drastically. Was well controlled before vaccine.

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

FieldPreferred term2021-092023-042024-11
SDAgeusia ✓ ✓ ✓
SDArthralgia ✓ · ✓
SDBlood glucose fluctuation ✓ · ✓
SDBlood glucose increased ✓ · ✓
SDDizziness ✓ ✓ ✓
SDDysgeusia ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDInjection site pain ✓ ✓ ✓
SDPain ✓ · ✓
SDTaste disorder ✓ ✓ ✓
SDVaccination site pain ✓ · ✓
SROBody temperature increased ✓ · ✓
SROInjection site discolouration ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓
SROUnevaluable event ○ ✓ ○

✓ active code · ○ coded but marked inactive · blank = not in that release