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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

  1. 2021-05-18
    Dose 1 — Moderna
  2. 2021-06-15
    Registered in v-safe
  3. 2021-06-15
    Dose 2 — Moderna
  4. 2021-06-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: 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 activities
    Free 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
  5. 2021-06-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: 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 activities
    Adult check-in
  6. 2021-07-20
    Survey response — day 35, dose 2
    MedDRA: Headache, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities
    Free 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
  7. 2021-07-27
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  8. 2021-12-28
    Dose 3 — Moderna
  9. 2022-07-13
    Dose 4 — Pfizer-BioNTech
  10. 2022-07-14
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches
    Adult check-in
  11. 2022-07-15
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  12. 2022-07-16
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches
    Adult check-in
  13. 2022-07-20
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  14. 2022-07-27
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  15. 2022-08-03
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  16. 2022-08-10
    Survey response — day 28, dose 4
    MedDRA: Headache — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Headaches off and on since yesterday.
    MedDRA releases: 2024-11 · check-in free text available
  17. 2022-08-17
    Survey response — day 35, dose 4
    MedDRA: Dizziness — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Just little light headedness it comes and goes.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-05-18Moderna
22021-06-15Moderna
32021-12-28Moderna No
42022-07-13Pfizer-BioNTech No

Free text

Release 9 — days 1–6 daily, dose 2

2021-06-17

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

2021-07-20

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

2022-08-10

Symptoms: Headaches off and on since yesterday.

Release 12 — day 35, dose 4

2022-08-17

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

FieldPreferred term2021-092023-042024-11
SDDizziness · · ✓
SDHeadache · · ✓
SDOropharyngeal pain · · ✓
SROHeadache ✓ ✓ ✓
SRONightmare ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROScreaming ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release