3QG-32661-53619
4 vaccinations
12 coded responses
49 check-ins
11 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 891 / NV
- Registered
- 2021-04-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-04-05
Registered in v-safe
-
2021-04-05
Dose 1 — Moderna
- 2021-04-05
-
2021-04-06
Survey response — days 1–6 daily, dose 1MedDRA: Photophobia — Feeling: Fair · Site: Pain · HeadacheFree text: Sensitivity to light/eyes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: Good · Fatigue or tirednessFree text: A little tired after a full nights sleep.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-19
- 2021-04-26
-
2021-05-03
Dose 2 — Moderna
-
2021-05-03
Survey response — day 0, dose 2MedDRA: Hypoaesthesia — Feeling: FairFree text: Teeth felt numb. Particularly my top front teeth.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-04
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia — Feeling: Fair · Site: Pain · Joint painsFree text: Top front teeth feel a little numb.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-06
- 2021-05-07
- 2021-05-08
-
2021-05-09
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-10
Survey response — day 7, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-17
- 2021-05-24
- 2021-05-31
- 2021-06-07
- 2021-06-14
- 2021-08-02
- 2021-11-01
-
2021-11-17
Dose 3 — Moderna
-
2021-11-19
Health check-in — days 1–6 daily, dose 3Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-20
-
2021-11-21
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Muscle or body achesFree text: NoneMedDRA releases: 2024-11 · check-in free text available
- 2021-11-22
- 2021-11-24
- 2021-12-01
- 2021-12-08
-
2021-12-15
Survey response — day 28, dose 3MedDRA: Prostatitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Prostatitis. Currently being treat with antibiotics.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-15
Report sent to call center — day 28, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-16
-
2021-12-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-22
- 2021-12-29
- 2022-02-16
-
2022-05-15
Dose 4 — Moderna
-
2022-05-15
Health check-in — day 0, dose 4Feeling: Fair · Site: Pain · Joint pains, Muscle or body achesAdult check-in
-
2022-05-16
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: GoodFree text: Not at this time.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-17
- 2022-05-18
- 2022-05-19
- 2022-05-20
- 2022-05-22
-
2022-05-29
Survey response — day 14, dose 4MedDRA: Diarrhoea, Flank pain — Feeling: FairFree text: Woke up with pain on my left side, loose stools, and what I believe may have been a kidney stone in the left ureter. I applied a heat pad and drank a bit of apple cider vinegar and cranberry. Pain passed after dozing off for 6 hours. Otherwise okay.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-05
- 2022-06-12
- 2022-06-19
- 2022-06-26
-
2022-08-15
Survey response — 3 months, dose 4MedDRA: Balance disorder, Condition aggravated, Joint stiffness, Pre-existing disease — Feeling: FairFree text: Hips very tense and balance a little off. Cataract condition in right eye progressing.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-13
-
2023-05-15
Survey response — 12 months, dose 4MedDRA: Arteriosclerosis, Intraocular pressure increased, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-05-15
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-05-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-05 | Moderna | |
| 2 | 2021-05-03 | Moderna | |
| 3 | 2021-11-17 | Moderna | No |
| 4 | 2022-05-15 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Sensitivity to light/eyes.
Systemic reaction (other): A little tired after a full nights sleep.
Release 8 — day 0, dose 2
Systemic reaction (other): Teeth felt numb. Particularly my top front teeth.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Top front teeth feel a little numb.
Systemic reaction (other): None
Release 8 — day 7, dose 2
Systemic reaction (other): No
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): None
Release 10 — day 28, dose 3
Symptoms: Prostatitis. Currently being treat with antibiotics.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Not at this time.
Release 11 — day 14, dose 4
Symptoms: Woke up with pain on my left side, loose stools, and what I believe may have been a kidney stone in the left ureter. I applied a heat pad and drank a bit of apple cider vinegar and cranberry. Pain passed after dozing off for 6 hours. Otherwise okay. cut off by CDC
Release 12 — 3 months, dose 4
Symptoms: Hips very tense and balance a little off. Cataract condition in right eye progressing.
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 | Arteriosclerosis | · | · | ✓ |
| SD | Balance disorder | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Flank pain | · | · | ✓ |
| SD | Intraocular pressure increased | · | · | ✓ |
| SD | Joint stiffness | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Prostatitis | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Photophobia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release