3GV-12503-14907
5 vaccinations
5 coded responses
40 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 301 / GA
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
-
2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · Site: Pain · HeadacheFree text: The headache started yesterday around 7:00 PM; and ended at 10:00 A M today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
-
2021-02-04
Survey response — day 14, dose 1MedDRA: Oral herpes — Feeling: GoodFree text: I developed a cold sore on my lip which was strange because I hadnt been around anybody. I dont know if its related or not it lasted for about five days its just about gone now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
-
2021-02-18
Dose 2 — Moderna
-
2021-02-25
Survey response — day 7, dose 2MedDRA: Chills, Pain — Feeling: Good · Site: Pain · Chills, Muscle or body achesFree text: I got the vaccination on Feb 18, 2021 For the first two days after the vaccination I had no symptoms on the third day I receive chills and aches and pains they were very mild and they lasted for about 24 hoursMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-02
- 2021-05-20
- 2021-08-19
-
2021-11-18
Dose 3 — Moderna
- 2022-02-18
-
2022-06-13
Dose 4 — Moderna
- 2022-06-13
- 2022-06-14
- 2022-06-15
- 2022-06-16
- 2022-06-17
- 2022-06-20
- 2022-06-27
- 2022-07-04
- 2022-07-11
- 2022-07-18
- 2022-07-25
- 2022-09-12
-
2022-12-14
Survey response — 6 months, dose 4MedDRA: Cough, Respiratory tract congestion — Feeling: GoodFree text: I had a cough and some congestion for about 3 days after the Thanksgiving gathering.MedDRA releases: 2024-11 · check-in free text available
-
2023-04-09
Dose 5 — Moderna
- 2023-04-12
- 2023-04-13
- 2023-04-14
- 2023-04-18
- 2023-04-23
- 2023-04-30
- 2023-05-07
- 2023-05-14
- 2023-05-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-18 | Moderna | |
| 3 | 2021-11-18 | Moderna | No |
| 4 | 2022-06-13 | Moderna | No |
| 5 | 2023-04-09 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): The headache started yesterday around 7:00 PM; and ended at 10:00 A M today.
Release 3 — day 14, dose 1
Symptoms: I developed a cold sore on my lip which was strange because I hadnt been around anybody. I dont know if its related or not it lasted for about five days its just about gone now.
Release 4 — day 7, dose 2
Systemic reaction (other): I got the vaccination on Feb 18, 2021 For the first two days after the vaccination I had no symptoms on the third day I receive chills and aches and pains they were very mild and they lasted for about 24 hours
Release 12 — 6 months, dose 4
Symptoms: I had a cough and some congestion for about 3 days after the Thanksgiving gathering.
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 | Oral herpes | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release