3MT-26330-47887
2 vaccinations
4 coded responses
10 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 935 / CA
- Registered
- 2021-04-30
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-31
Dose 1 — Moderna
-
2021-04-28
Dose 2 — Moderna
-
2021-04-30
Registered in v-safe
-
2021-04-30
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Dizziness, Paraesthesia — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Dizzyness, tingling extremities, pins and needles type pain, shoulder pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
- 2021-05-03
- 2021-05-06
- 2021-05-12
-
2021-05-21
Survey response — day 21, dose 2MedDRA: Injection site discomfort, Injection site pain — Feeling: Good · Be unable to workFree text: Left arm hurts like hell at night around injection site and sensitive to cell phone frequency .MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-28
Survey response — day 28, dose 2MedDRA: Office visit, Pain in extremity, Toothache — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: My left arm aches around injection site and my bottom teeth are hurting real bad and even decaying and breaking since the 2nd dose especial whenever my cell phone is near me or rings or im indoors where theres a lot of electronic devices. Real weird. · Healthcare visit (other): 1st wellness exam and says im 100 percent healthy. 2nd i saw Dentist and they dont know whats going on but they perscribed me motrin and antibiotics.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-28
Report sent to call center — day 28, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-28
-
2021-10-28
Survey response — 6 months, dose 2MedDRA: Injection site pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: My left arm where i got the shot hurts like hell in certain places like project roomkey room 245 and in the motel room i was at and only in certain places or positions under these ceilings and certain wall areas directly under 3 squares pertrudingMedDRA releases: 2024-11 · check-in free text available
- 2022-04-28
- 2022-04-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-28 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Dizzyness, tingling extremities, pins and needles type pain, shoulder pain.
Release 8 — day 21, dose 2
Symptoms: Left arm hurts like hell at night around injection site and sensitive to cell phone frequency .
Release 8 — day 28, dose 2
Symptoms: My left arm aches around injection site and my bottom teeth are hurting real bad and even decaying and breaking since the 2nd dose especial whenever my cell phone is near me or rings or im indoors where theres a lot of electronic devices. Real weird. cut off by CDC
Healthcare visit (other): 1st wellness exam and says im 100 percent healthy. 2nd i saw Dentist and they dont know whats going on but they perscribed me motrin and antibiotics.
Release 10 — 6 months, dose 2
Symptoms: My left arm where i got the shot hurts like hell in certain places like project roomkey room 245 and in the motel room i was at and only in certain places or positions under these ceilings and certain wall areas directly under 3 squares pertruding
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Injection site discomfort | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Toothache | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release