39W-31967-02715
4 vaccinations
12 coded responses
52 check-ins
12 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 926 / CA
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-18
Registered in v-safe
-
2021-03-18
Dose 1 — Moderna
-
2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: GoodFree text: tired a littleMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
-
2021-04-19
Dose 2 — Moderna
-
2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal discomfort, Axillary pain, Back pain, Headache, Lymphadenopathy, Pain, Pyrexia — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: left armpit pain and gland swelling, back pain by the waist (kidneys), fever high on second day, entire body aches, upset stomach, headache, all came down beginning 3rd dayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal discomfort — Feeling: Good · Site: PainFree text: upset stomatchMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-05-24
- 2021-05-31
- 2021-07-19
- 2021-10-18
-
2021-10-27
Dose 3 — Moderna
-
2021-10-27
Survey response — day 0, dose 3MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Muscle or body achesFree text: pain at the injection areaMedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: under injected arm lymph node painMedDRA releases: 2024-11 · check-in free text available
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: stuffing noseMedDRA releases: 2024-11 · check-in free text available
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: under arm lymph node still pain a littleMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
-
2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion, Rhinorrhoea — Feeling: Good · Fatigue or tirednessFree text: stuffing/running noseMedDRA releases: 2024-11 · check-in free text available
-
2021-11-03
Survey response — day 7, dose 3MedDRA: Nasal congestion, Rhinorrhoea — Feeling: Good · Fatigue or tirednessFree text: stuffing/running noseMedDRA releases: 2024-11 · check-in free text available
- 2021-11-10
- 2021-11-17
- 2021-11-24
-
2021-12-01
Survey response — day 35, dose 3MedDRA: Fatigue, Pyrexia — Feeling: FairFree text: tired and low grade fewerMedDRA releases: 2024-11 · check-in free text available
- 2021-12-08
- 2022-01-26
-
2022-04-14
Dose 4 — Moderna
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2022-04-14
Survey response — day 0, dose 4MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Sore at injection areaMedDRA releases: 2024-11 · check-in free text available
-
2022-04-15
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2022-04-16
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-17
- 2022-04-18
- 2022-04-19
-
2022-04-20
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessAdult check-in
- 2022-04-23
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-19
- 2022-05-26
- 2022-07-14
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2022-10-13
Survey response — 6 months, dose 4MedDRA: Chest pain — Feeling: FairFree text: About 1-2 times a week, I got mild pain at upper left of my chest. This lasts around 2-3 hours. Most the time it happened eatly morning 3am -6am, while I am in bed. I never have this pain before.MedDRA releases: 2024-11 · check-in free text available
- 2023-04-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-19 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-14 | Moderna | No |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): tired a little
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): left armpit pain and gland swelling, back pain by the waist (kidneys), fever high on second day, entire body aches, upset stomach, headache, all came down beginning 3rd day
Systemic reaction (other): upset stomatch
Release 10 — day 0, dose 3
Systemic reaction (other): pain at the injection area
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): under injected arm lymph node pain
Systemic reaction (other): stuffing nose
Systemic reaction (other): under arm lymph node still pain a little
Systemic reaction (other): stuffing/running nose
Release 10 — day 7, dose 3
Systemic reaction (other): stuffing/running nose
Release 10 — day 35, dose 3
Symptoms: tired and low grade fewer
Release 11 — day 0, dose 4
Systemic reaction (other): Sore at injection area
Release 12 — 6 months, dose 4
Symptoms: About 1-2 times a week, I got mild pain at upper left of my chest. This lasts around 2-3 hours. Most the time it happened eatly morning 3am -6am, while I am in bed. I never have this pain before.
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 | Chest pain | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release