3C5-50845-53565
5 vaccinations
10 coded responses
58 check-ins
10 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 958 / CA
- Registered
- 2021-02-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-02-08
Registered in v-safe
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2021-02-08
Dose 1 — Moderna
- 2021-02-08
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2021-02-09
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: Pain · Muscle or body achesFree text: I Feel good.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-15
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2021-02-22
Survey response — day 14, dose 1MedDRA: Fatigue, Lymph node pain, Lymphadenopathy, Muscular weakness — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Slightly swollen gland right side of neck, tender to touch and more fatigue than usual including weakness in legs.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Survey response — day 21, dose 1MedDRA: Rash pruritic — Feeling: GoodFree text: Itching rash below ankles but not on foot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-08
Dose 2 — Moderna
- 2021-03-08
-
2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-10
-
2021-03-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-12
- 2021-03-13
-
2021-03-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2021-03-17
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2021-03-22
Survey response — day 14, dose 2MedDRA: Vertigo — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Mild case of Vertigo.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-30
- 2021-04-05
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2021-04-12
Survey response — day 35, dose 2MedDRA: Rash, Rash pruritic, Self-medication — Feeling: GoodFree text: Ankle and foot rash very itchy. Applying itch cream as needed.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-19
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2021-06-07
Survey response — 3 months, dose 2MedDRA: Abdominal distension, Chest pain, Pain, Sleep disorder — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Mid section beneath sternum to belly button very sore with bloating since mid May. Better today. Could be stomach or intestinal issue. Affected sleep. Had to sleep in lazy boy several nights because sides were too painful to turn over on.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-09-06
Survey response — 6 months, dose 2MedDRA: Abdominal pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Acute abdominal pain. Im scheduled for GI procedures to determine whats causing the pain. Ultrasound was unremarkable.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-06
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-09-24
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2021-10-29
Dose 3 — Moderna
- 2021-10-29
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-31
- 2021-11-01
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2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-11-04
Survey response — days 1–6 daily, dose 3MedDRA: Neck pain — Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Sore neckMedDRA releases: 2024-11 · check-in free text available
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2021-11-07
Health check-in — day 7, dose 3Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-11-14
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2022-01-29
- 2022-04-29
-
2022-05-20
Dose 4 — Moderna
- 2022-05-20
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2022-05-21
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Chills, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
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2022-05-22
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-23
- 2022-05-24
- 2022-05-25
- 2022-05-26
- 2022-05-30
- 2022-06-03
- 2022-06-10
- 2022-06-18
- 2022-06-24
- 2022-07-01
- 2022-08-19
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2022-09-21
Dose 5 — ModernaCo-administered: Flu
- 2022-10-12
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2022-10-19
Survey response — day 28, dose 5MedDRA: Abdominal pain upper — Feeling: FairFree text: StomachacheMedDRA releases: 2024-11 · check-in free text available
- 2022-10-26
- 2022-11-02
-
2022-12-21
Survey response — 3 months, dose 5MedDRA: Cough — Feeling: GoodFree text: Persistent coughMedDRA releases: 2024-11 · check-in free text available
- 2023-03-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-08 | Moderna | |
| 2 | 2021-03-08 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-05-20 | Moderna | No |
| 5 | 2022-09-21 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): I Feel good.
Release 4 — day 14, dose 1
Symptoms: Slightly swollen gland right side of neck, tender to touch and more fatigue than usual including weakness in legs.
Release 4 — day 21, dose 1
Symptoms: Itching rash below ankles but not on foot.
Release 6 — day 14, dose 2
Symptoms: Mild case of Vertigo.
Release 7 — day 35, dose 2
Symptoms: Ankle and foot rash very itchy. Applying itch cream as needed.
Release 8 — 3 months, dose 2
Symptoms: Mid section beneath sternum to belly button very sore with bloating since mid May. Better today. Could be stomach or intestinal issue. Affected sleep. Had to sleep in lazy boy several nights because sides were too painful to turn over on.
Release 9 — 6 months, dose 2
Symptoms: Acute abdominal pain. Im scheduled for GI procedures to determine whats causing the pain. Ultrasound was unremarkable.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sore neck
Release 12 — day 28, dose 5
Symptoms: Stomachache
Release 12 — 3 months, dose 5
Symptoms: Persistent cough
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 | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Abdominal pain | ✓ | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Lymph node pain | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Muscular weakness | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Sleep disorder | ✓ | ✓ | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SRO | Neck pain | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release