3KZ-15859-10433
2 vaccinations
11 coded responses
26 check-ins
11 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 31-35
- ZIP prefix
- 487 / MI
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
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2020-12-28
Dose 1 — Moderna
- 2020-12-28
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2020-12-29
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
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2020-12-30
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2020-12-31
- 2021-01-01
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2021-01-02
Survey response — days 1–6 daily, dose 1MedDRA: Tinnitus — Feeling: GoodFree text: Intensifying tinnitus possibly secondary to ear infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-03
Survey response — days 1–6 daily, dose 1MedDRA: Tinnitus — Feeling: GoodFree text: Likely pulsative tinnitus, but probably not related to vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-04
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2021-01-11
Survey response — day 14, dose 1MedDRA: Deafness, Deafness unilateral — Feeling: GoodFree text: High-frequency hearing loss in left ear - hopefully reversible and related to being plugged or infected.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-18
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2021-01-25
Dose 2 — Moderna
- 2021-01-25
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2021-01-26
Survey response — days 1–6 daily, dose 2MedDRA: Tinnitus — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: TinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-27
Survey response — days 1–6 daily, dose 2MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: TinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-28
Survey response — days 1–6 daily, dose 2MedDRA: Tinnitus — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-29
Survey response — days 1–6 daily, dose 2MedDRA: Tinnitus — Feeling: Fair · Fatigue or tirednessFree text: tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-30
Survey response — days 1–6 daily, dose 2MedDRA: Tinnitus — Feeling: GoodFree text: tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-31
Survey response — days 1–6 daily, dose 2MedDRA: Tinnitus — Feeling: Good · Fatigue or tirednessFree text: TinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-01
Survey response — day 7, dose 2MedDRA: Tinnitus — Feeling: Good · Fatigue or tirednessFree text: tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-08
Survey response — day 14, dose 2MedDRA: Asthenia, Chills, Impaired work ability, Odynophagia, Pharyngeal disorder, Pyrexia, Streptococcal infection — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: I have white spots on the back of my throat. It is likely Strep throat. It hurts to swallow, I have had several days of fevers and chills and low energy. I had to skip work.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-04-27
- 2021-07-26
- 2022-01-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Intensifying tinnitus possibly secondary to ear infection
Systemic reaction (other): Likely pulsative tinnitus, but probably not related to vaccine
Release 1 — day 14, dose 1
Symptoms: High-frequency hearing loss in left ear - hopefully reversible and related to being plugged or infected.
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Tinnitus
Systemic reaction (other): Tinnitus
Systemic reaction (other): tinnitus
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): tinnitus
Systemic reaction (other): tinnitus
Systemic reaction (other): Tinnitus
Release 3 — day 7, dose 2
Systemic reaction (other): tinnitus
Release 3 — day 14, dose 2
Symptoms: I have white spots on the back of my throat. It is likely Strep throat. It hurts to swallow, I have had several days of fevers and chills and low energy. I had to skip work.
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 | Asthenia | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Deafness | ✓ | ✓ | ✓ |
| SD | Deafness unilateral | ✓ | ✓ | ✓ |
| SD | Impaired work ability | ✓ | ✓ | ✓ |
| SD | Odynophagia | ✓ | ✓ | ✓ |
| SD | Pharyngeal disorder | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Streptococcal infection | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release