3L6-20717-55209
4 vaccinations
4 coded responses
12 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 928 / CA
- Registered
- 2021-06-15
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
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2021-05-18
Dose 1 — Moderna
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2021-06-15
Registered in v-safe
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2021-06-15
Dose 2 — Moderna
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2021-06-17
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Nightmare, Oropharyngeal pain, Screaming — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I've had nightmares for 4 days after the first dose in which I would either yell at the top of my lungs and waking up all family members or have very vivid nightmares. The second dose has left me with soar throat, occasional headaches, and etc.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-19
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-07-20
Survey response — day 35, dose 2MedDRA: Headache, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Few headaches and felt as if I had a bit of a soar throat coming on which has subsided.MedDRA releases: 2024-11 · check-in free text available
- 2021-07-27
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2021-12-28
Dose 3 — Moderna
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2022-07-13
Dose 4 — Pfizer-BioNTech
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2022-07-14
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body achesAdult check-in
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2022-07-15
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-07-16
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body achesAdult check-in
- 2022-07-20
- 2022-07-27
- 2022-08-03
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2022-08-10
Survey response — day 28, dose 4MedDRA: Headache — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Headaches off and on since yesterday.MedDRA releases: 2024-11 · check-in free text available
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2022-08-17
Survey response — day 35, dose 4MedDRA: Dizziness — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Just little light headedness it comes and goes.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-18 | Moderna | |
| 2 | 2021-06-15 | Moderna | |
| 3 | 2021-12-28 | Moderna | No |
| 4 | 2022-07-13 | Pfizer-BioNTech | No |
Free text
Release 9 — days 1–6 daily, dose 2
Systemic reaction (other): I've had nightmares for 4 days after the first dose in which I would either yell at the top of my lungs and waking up all family members or have very vivid nightmares. The second dose has left me with soar throat, occasional headaches, and etc.
Release 9 — day 35, dose 2
Symptoms: Few headaches and felt as if I had a bit of a soar throat coming on which has subsided.
Release 12 — day 28, dose 4
Symptoms: Headaches off and on since yesterday.
Release 12 — day 35, dose 4
Symptoms: Just little light headedness it comes and goes.
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 | Dizziness | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Nightmare | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Screaming | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release