3D5-30009-28851
4 vaccinations
10 coded responses
41 check-ins
9 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 928 / CA
- Registered
- 2021-02-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Registered dependents
DSW-67411-37783
Adult relative or friend · Female · 2021-10-30
Timeline
-
2021-02-12
Dose 1 — Moderna
-
2021-02-14
Registered in v-safe
- 2021-02-14
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-20
- 2021-02-26
- 2021-03-06
- 2021-03-12
-
2021-03-19
Dose 2 — Moderna
-
2021-03-20
Survey response — days 1–6 daily, dose 2MedDRA: Eye pain, Headache, Influenza like illness, Sinus congestion — Feeling: Good · Site: Pain · HeadacheFree text: Very mild Flu like symptoms, as: light eyes ache, , like head ache, and light sinus congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-21
Survey response — days 1–6 daily, dose 2MedDRA: Influenza like illness — Feeling: Good · Joint painsFree text: Flu like mild symptoms I had, are gone now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-23
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: Good · Joint painsFree text: Cameback to normal. Only having slight Joints Pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
-
2021-06-20
Survey response — 3 months, dose 2MedDRA: Oropharyngeal pain, Paranasal sinus hypersecretion, Pharyngitis, Pruritus — Feeling: GoodFree text: Faringitis for the last two weeks. Sore upper throat and nasal sinuses. Symptoms are mild, very very itchy. I will consult with my Family Practice Doctor, next week. Unsure if related to Moderna Second doze vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-09-17
-
2021-10-25
Dose 3 — Moderna
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Fatigue, Somnolence — Feeling: Good · Fatigue or tirednessFree text: Sleepy and tired in the afternoon of day afterMedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Fatigue, Somnolence — Feeling: Good · Fatigue or tirednessFree text: Tired and sleepy. Needed to take an afternoon nap.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Somnolence — Feeling: GoodFree text: Sleepiness at mid day. Took a nap.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Somnolence — Feeling: GoodFree text: Sleepy at mid day. I took a nap.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
-
2021-11-01
Survey response — day 7, dose 3MedDRA: Fatigue — Feeling: Good · Fatigue or tirednessFree text: Slight fatigue at mid dayMedDRA releases: 2024-11 · check-in free text available
- 2021-11-09
- 2021-11-17
- 2021-12-01
- 2021-12-08
- 2022-01-27
-
2022-04-27
Dose 4 — Moderna
- 2022-04-29
- 2022-05-15
- 2022-05-20
- 2022-05-25
- 2022-06-01
- 2022-06-08
- 2022-07-27
- 2022-10-26
-
2023-04-27
Survey response — 12 months, dose 4MedDRA: Cough, Oropharyngeal pain, Productive cough, Upper-airway cough syndrome — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-04-27
Report sent to call center — 12 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-12 | Moderna | |
| 2 | 2021-03-19 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-27 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Very mild Flu like symptoms, as: light eyes ache, , like head ache, and light sinus congestion
Systemic reaction (other): Flu like mild symptoms I had, are gone now.
Systemic reaction (other): Cameback to normal. Only having slight Joints Pain.
Release 9 — 3 months, dose 2
Symptoms: Faringitis for the last two weeks. Sore upper throat and nasal sinuses. Symptoms are mild, very very itchy. I will consult with my Family Practice Doctor, next week. Unsure if related to Moderna Second doze vaccine.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sleepy and tired in the afternoon of day after
Systemic reaction (other): Tired and sleepy. Needed to take an afternoon nap.
Systemic reaction (other): Sleepiness at mid day. Took a nap.
Systemic reaction (other): Sleepy at mid day. I took a nap.
Release 10 — day 7, dose 3
Systemic reaction (other): Slight fatigue at mid day
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 | Cough | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Paranasal sinus hypersecretion | ✓ | ✓ | ✓ |
| SD | Pharyngitis | ✓ | ✓ | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Influenza like illness | ✓ | ✓ | ✓ |
| SRO | Sinus congestion | ✓ | ✓ | ✓ |
| SRO | Somnolence | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release