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
-
2021-01-02
Registered in v-safe
-
2021-01-02
Dose 1 — Moderna
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-06
- 2021-01-07
- 2021-01-09
- 2021-01-16
- 2021-01-23
- 2021-01-30
-
2021-02-03
Dose 2 — Moderna
-
2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-05
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Self-medication, Unevaluable event — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessFree text: I had a fever of 100.0 last night after my survey. Controlled with TylenolMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Injection site discolouration — Feeling: Good · Site: Pain · Joint pains, Muscle or body achesFree text: Discoloration at injection sight noticed last nightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
- 2021-02-09
- 2021-02-10
-
2021-02-19
Survey response — day 14, dose 2MedDRA: Dizziness, Fatigue, Injection site pain, Taste disorder — Feeling: GoodFree 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
- 2021-02-25
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2021-03-04
Survey response — day 28, dose 2MedDRA: Dysgeusia — Feeling: GoodFree text: My taste has been off.. decreased and having a metallic taste intermittentlyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Survey response — day 35, dose 2MedDRA: Ageusia, Dysgeusia — Feeling: GoodFree text: My taste is off.. having metallic taste on and off. Slight decrease in taste. Smell not effected at allMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
- 2021-05-05
-
2021-08-04
Survey response — 6 months, dose 2MedDRA: Arthralgia, Blood glucose fluctuation, Blood glucose increased, Fatigue, Pain, Vaccination site pain — Feeling: FairFree 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
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-02 | Moderna | |
| 2 | 2021-02-03 | Moderna |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): I had a fever of 100.0 last night after my survey. Controlled with Tylenol
Systemic reaction (other): Discoloration at injection sight noticed last night
Release 4 — day 14, dose 2
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
Symptoms: My taste has been off.. decreased and having a metallic taste intermittently
Release 5 — day 35, dose 2
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Ageusia | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | · | ✓ |
| SD | Blood glucose fluctuation | ✓ | · | ✓ |
| SD | Blood glucose increased | ✓ | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dysgeusia | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | · | ✓ |
| SD | Taste disorder | ✓ | ✓ | ✓ |
| SD | Vaccination site pain | ✓ | · | ✓ |
| SRO | Body temperature increased | ✓ | · | ✓ |
| SRO | Injection site discolouration | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ○ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release