3H4-95095-88418
5 vaccinations
5 coded responses
68 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 910 / CA
- Registered
- 2021-01-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-31
Registered in v-safe
-
2021-01-31
Dose 1 — Moderna
- 2021-01-31
- 2021-02-01
-
2021-02-02
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: PainFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-03
- 2021-02-04
-
2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Lip swelling, Oral discomfort — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Fogot to mention on day 1 after injection: burning sensation & swelling at lower right lip similar to a herpes simplex reaction that came up 1 day after injection & continues to be an issue today (2/5/2021)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Burning sensation, Lip swelling — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: As reported yesterday & continues today, I have a burning sensation & swelling at lower right lip similar to a herpes simplex reaction that came up 1 day after injection & continues to be an issue today (2/6/2021). The swelling & puffiness of the area has not decreased nor dimished.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-07
Survey response — day 7, dose 1MedDRA: Lip swelling, Oral discomfort — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: As reported previously, burning & sensation at lower right lip similar to a herpes simplex reaction that came up 1 day after injection& continues to be an issue today 2/7/2021 except te swelling & puffiness of the area has decreased & dimished but has not gone away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
- 2021-02-21
- 2021-02-28
-
2021-03-06
Dose 2 — Moderna
-
2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
-
2021-04-17
Survey response — day 42, dose 2MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Minor sore throat for the past few weeks.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-05
- 2021-09-04
-
2021-10-25
Dose 3 — Moderna
- 2021-10-25
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-16
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
- 2022-04-27
-
2022-04-30
Dose 4 — Moderna
- 2022-04-30
- 2022-05-01
- 2022-05-02
- 2022-05-03
- 2022-05-04
- 2022-05-06
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-05-28
- 2022-06-04
- 2022-06-11
- 2022-07-30
-
2022-10-19
Dose 5 — Moderna
- 2022-10-19
- 2022-10-20
- 2022-10-21
- 2022-10-22
- 2022-10-23
- 2022-10-24
- 2022-10-25
- 2022-10-26
- 2022-11-02
- 2022-11-09
- 2022-11-16
- 2022-11-23
- 2022-11-30
- 2023-01-18
- 2023-04-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-31 | Moderna | |
| 2 | 2021-03-06 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-30 | Moderna | No |
| 5 | 2022-10-19 | Moderna | No |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): No
Systemic reaction (other): Fogot to mention on day 1 after injection: burning sensation & swelling at lower right lip similar to a herpes simplex reaction that came up 1 day after injection & continues to be an issue today (2/5/2021)
Systemic reaction (other): As reported yesterday & continues today, I have a burning sensation & swelling at lower right lip similar to a herpes simplex reaction that came up 1 day after injection & continues to be an issue today (2/6/2021). The swelling & puffiness of the area has not decreased nor dimished.
Release 3 — day 7, dose 1
Systemic reaction (other): As reported previously, burning & sensation at lower right lip similar to a herpes simplex reaction that came up 1 day after injection& continues to be an issue today 2/7/2021 except te swelling & puffiness of the area has decreased & dimished but has not gone away.
Release 7 — day 42, dose 2
Symptoms: Minor sore throat for the past few weeks.
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 | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Burning sensation | ✓ | ✓ | ✓ |
| SRO | Lip swelling | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Oral discomfort | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release