3C6-15316-25908
4 vaccinations
13 coded responses
43 check-ins
13 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 190 / PA
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-06
Dose 1 — Moderna
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2021-02-11
Registered in v-safe
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2021-02-11
Survey response — days 1–6 daily, dose 1MedDRA: Dyspepsia — Feeling: Fair · Site: PainFree text: HeartburnMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-12
- 2021-02-13
- 2021-02-20
- 2021-02-27
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2021-03-06
Dose 2 — Moderna
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2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, HeadacheAdult check-in
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2021-03-10
Survey response — days 1–6 daily, dose 2MedDRA: Rhinorrhoea, Sneezing — Feeling: Fair · Fatigue or tirednessFree text: Runny nose & some sneezingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-12
- 2021-03-14
- 2021-03-20
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2021-03-27
Survey response — day 21, dose 2MedDRA: Flatulence, Gastrooesophageal reflux disease — Feeling: GoodFree text: Stomach gas followed followed by Severe acid refluxMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-03
Survey response — day 28, dose 2MedDRA: Headache, Rhinorrhoea — Feeling: GoodFree text: Some headaches & runny nose. But feel fine today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-17
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2021-06-05
Survey response — 3 months, dose 2MedDRA: Pre-existing disease, Rhinorrhoea — Feeling: GoodFree text: Runny nose. Hope it's allergiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-09-04
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2021-10-28
Dose 3 — Moderna
- 2021-10-30
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
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2021-11-11
Survey response — day 14, dose 3MedDRA: Sneezing — Feeling: GoodFree text: Sneezing a few days ago. Fine now.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-18
- 2021-11-25
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2021-12-02
Survey response — day 35, dose 3MedDRA: Sneezing — Feeling: GoodFree text: I've been sneezing a lot latelyMedDRA releases: 2024-11 · check-in free text available
- 2021-12-09
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2022-01-27
Survey response — 3 months, dose 3MedDRA: COVID-19, Cough, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive, Sinus headache — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I am NOW suffering from Covid 19. I tested POSITIVE on Saturday 1/22/22. However today feeling much better with lessened runny nose, cough & sore throat. But, more headaches which feel like from sinus.MedDRA releases: 2024-11 · check-in free text available
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2022-01-27
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-02-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-04-28
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2022-05-23
Dose 4 — Moderna
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2022-05-27
Survey response — days 1–6 daily, dose 4MedDRA: Office visit, Toothache — Feeling: Good · Site: PainFree text: Tooth pain Dentist thinks needs root canalMedDRA releases: 2024-11 · check-in free text available
- 2022-05-28
- 2022-05-29
- 2022-05-30
- 2022-06-06
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2022-06-13
Survey response — day 21, dose 4MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Yesterday had mild sore throatMedDRA releases: 2024-11 · check-in free text available
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2022-06-20
Survey response — day 28, dose 4MedDRA: Fatigue — Feeling: GoodFree text: TiredMedDRA releases: 2024-11 · check-in free text available
- 2022-06-27
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2022-07-04
Survey response — day 42, dose 4MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Off & on sore throat for past week. But tested negative.MedDRA releases: 2024-11 · check-in free text available
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2022-08-22
Survey response — 3 months, dose 4MedDRA: Ear neoplasm malignant, Office visit, Pain in extremity, Squamous cell carcinoma — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Squamous cell carcinoma on ear, leg pain. · Healthcare visit (other): Doctor office visitMedDRA releases: 2024-11 · check-in free text available
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2022-08-22
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-08-23
- 2022-11-21
- 2023-05-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-06 | Moderna | |
| 2 | 2021-03-06 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-05-23 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Heartburn
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Runny nose & some sneezing
Release 6 — day 21, dose 2
Symptoms: Stomach gas followed followed by Severe acid reflux
Release 6 — day 28, dose 2
Symptoms: Some headaches & runny nose. But feel fine today.
Release 8 — 3 months, dose 2
Symptoms: Runny nose. Hope it's allergies
Release 10 — day 14, dose 3
Symptoms: Sneezing a few days ago. Fine now.
Release 10 — day 35, dose 3
Symptoms: I've been sneezing a lot lately
Release 11 — 3 months, dose 3
Symptoms: I am NOW suffering from Covid 19. I tested POSITIVE on Saturday 1/22/22. However today feeling much better with lessened runny nose, cough & sore throat. But, more headaches which feel like from sinus.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Tooth pain Dentist thinks needs root canal
Release 12 — day 21, dose 4
Symptoms: Yesterday had mild sore throat
Release 12 — day 28, dose 4
Symptoms: Tired
Release 12 — day 42, dose 4
Symptoms: Off & on sore throat for past week. But tested negative.
Release 12 — 3 months, dose 4
Symptoms: Squamous cell carcinoma on ear, leg pain.
Healthcare visit (other): Doctor office visit
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 | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ear neoplasm malignant | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Flatulence | ✓ | ✓ | ✓ |
| SD | Gastrooesophageal reflux disease | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinus headache | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Squamous cell carcinoma | · | · | ✓ |
| SRO | Dyspepsia | ✓ | ✓ | ✓ |
| SRO | Office visit | · | · | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Sneezing | ✓ | ✓ | ✓ |
| SRO | Toothache | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release