3CX-20152-28284
5 vaccinations
17 coded responses
62 check-ins
15 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 376 / TN
- Registered
- 2021-03-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-01
Registered in v-safe
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2021-03-01
Dose 1 — Moderna
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2021-03-01
Survey response — day 0, dose 1MedDRA: Burning sensation — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: I felt the vaccine in my vascular system as a burning sensation for less than a minute.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-02
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
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2021-03-03
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
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2021-03-15
Survey response — day 14, dose 1MedDRA: Arthralgia, Injection site pain — Feeling: GoodFree text: Sore shoulder where shot was given came back.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
- 2021-03-29
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2021-04-02
Dose 2 — Moderna
- 2021-04-05
- 2021-04-06
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2021-04-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Abdominal painAdult check-in
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-07-05
- 2021-10-01
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2021-11-15
Dose 3 — Moderna
- 2021-11-15
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2021-11-16
Survey response — days 1–6 daily, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Muscle or body achesFree text: The booster shot aggravated my V-Fib for about 4 hrs yesterday eve.MedDRA releases: 2024-11 · check-in free text available
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2021-11-17
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-11-18
- 2021-11-19
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2021-11-20
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
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2021-11-21
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Joint pains, Muscle or body achesAdult check-in
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2021-11-22
Health check-in — day 7, dose 3Feeling: Good · Site: Pain · Joint pains, Muscle or body achesAdult check-in
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2021-11-29
Survey response — day 14, dose 3MedDRA: Headache, Sinus congestion — Feeling: GoodFree text: Sinus congestion and mild headachesMedDRA releases: 2024-11 · check-in free text available
- 2021-12-06
- 2021-12-13
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2021-12-20
Survey response — day 35, dose 3MedDRA: Arthralgia, Headache — Feeling: GoodFree text: Occasional headache. Shoulder joint aches occasionally.MedDRA releases: 2024-11 · check-in free text available
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2021-12-27
Survey response — day 42, dose 3MedDRA: Cough, Headache, Nasopharyngitis, Respiratory tract congestion — Feeling: FairFree text: Head cold, chest and head congestion, coughing, head aches.MedDRA releases: 2024-11 · check-in free text available
- 2022-02-14
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2022-04-19
Dose 4 — Moderna
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2022-04-21
Survey response — days 1–6 daily, dose 4MedDRA: Back pain — Feeling: Fair · Site: PainFree text: Low back painMedDRA releases: 2024-11 · check-in free text available
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-05-03
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2022-05-10
Survey response — day 21, dose 4MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: FairFree text: Head congestion and sore throat.MedDRA releases: 2024-11 · check-in free text available
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2022-05-17
Survey response — day 28, dose 4MedDRA: Respiratory tract congestion — Feeling: FairFree text: Head and chest congestion.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-24
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2022-05-31
Survey response — day 42, dose 4MedDRA: Sinus congestion — Feeling: GoodFree text: Sinus congestionMedDRA releases: 2024-11 · check-in free text available
- 2022-07-19
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2022-10-17
Dose 5 — Moderna
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2022-10-17
Survey response — day 0, dose 5MedDRA: Burning sensation — Feeling: GoodFree text: The first hour after the shot, my arm felt a slight burning in my forearm.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-18
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2022-10-20
Survey response — days 1–6 daily, dose 5MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
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2022-10-21
Survey response — days 1–6 daily, dose 5MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
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2022-10-22
Survey response — days 1–6 daily, dose 5MedDRA: Rhinorrhoea — Feeling: Good · Site: PainFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
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2022-10-23
Survey response — days 1–6 daily, dose 5MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2022-11-21
- 2022-11-28
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2023-01-16
Survey response — 3 months, dose 5MedDRA: Nasopharyngitis, Sinusitis — Feeling: GoodMedDRA releases: 2024-11
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2023-04-17
Survey response — 6 months, dose 5MedDRA: Bronchitis, Office visit, Pre-existing disease, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
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2023-04-17
Report sent to call center — 6 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2023-04-18
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-01 | Moderna | |
| 2 | 2021-04-02 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-04-19 | Moderna | No |
| 5 | 2022-10-17 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): I felt the vaccine in my vascular system as a burning sensation for less than a minute.
Release 5 — day 14, dose 1
Symptoms: Sore shoulder where shot was given came back.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): The booster shot aggravated my V-Fib for about 4 hrs yesterday eve.
Release 10 — day 14, dose 3
Symptoms: Sinus congestion and mild headaches
Release 10 — day 35, dose 3
Symptoms: Occasional headache. Shoulder joint aches occasionally.
Release 10 — day 42, dose 3
Symptoms: Head cold, chest and head congestion, coughing, head aches.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Low back pain
Release 11 — day 21, dose 4
Symptoms: Head congestion and sore throat.
Release 11 — day 28, dose 4
Symptoms: Head and chest congestion.
Release 11 — day 42, dose 4
Symptoms: Sinus congestion
Release 12 — day 0, dose 5
Systemic reaction (other): The first hour after the shot, my arm felt a slight burning in my forearm.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Runny nose
Systemic reaction (other): Runny nose
Systemic reaction (other): Runny nose
Systemic reaction (other): Runny nose
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Back pain | · | · | ✓ |
| SRO | Burning sensation | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release