3WN-84102-79044
5 vaccinations
9 coded responses
57 check-ins
9 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 032 / NH
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-09
Dose 1 — Moderna
-
2021-03-10
Registered in v-safe
- 2021-03-11
- 2021-03-12
- 2021-03-13
-
2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Arthritis, Condition aggravated, Pre-existing disease — Feeling: GoodFree text: Im T 2 diabetic with arthritis so my response to this is nothing newMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-15
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
-
2021-04-07
Dose 2 — Moderna
- 2021-04-07
-
2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Condition aggravated, Hypoglycaemia, Pre-existing disease — Feeling: Fair · Fatigue or tirednessFree text: Hypoglycemic episode at 0530 hrsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-09
- 2021-04-10
-
2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Pain in jaw, Toothache — Feeling: Fair · Joint painsFree text: Joint pain is in my jaw and teeth on the left sideMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
-
2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Hypoglycaemia — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I had a hypoglycemic incident this morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-07-07
- 2021-10-06
-
2021-10-25
Dose 3 — ModernaCo-administered: Flu
- 2021-10-29
- 2021-10-30
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Hypoglycaemia — Feeling: Poor · Chills, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: I was hypoglycemic at 0330 hrs still recoveringMedDRA releases: 2024-11 · check-in free text available
-
2021-11-01
Survey response — day 7, dose 3MedDRA: Pre-existing disease — Feeling: Good · Joint pains · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: I have moderate arthritis in both my kneesMedDRA releases: 2024-11 · check-in free text available
-
2021-11-01
Report sent to call center — day 7, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-04
-
2021-11-04
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-08
-
2021-11-15
Survey response — day 21, dose 3MedDRA: Arthritis, Pre-existing disease, Sneezing — Feeling: FairFree text: My arthritis is acting up a little bit and I was sneezing so I assume it's from dust allergiesMedDRA releases: 2024-11 · check-in free text available
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-25
Survey response — 6 months, dose 3MedDRA: Pneumonia — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: pneumoniaMedDRA releases: 2024-11 · check-in free text available
-
2022-04-25
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-04-26
-
2022-04-27
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-07
Dose 4 — Moderna
- 2022-05-18
- 2022-05-21
- 2022-05-28
- 2022-06-04
- 2022-06-11
- 2022-06-18
- 2022-08-06
-
2022-10-10
Dose 5 — ModernaCo-administered: Flu
- 2022-10-10
- 2022-10-11
- 2022-10-12
-
2022-10-13
Survey response — days 1–6 daily, dose 5MedDRA: Positive airway pressure therapy, Sinus headache — Feeling: Fair · HeadacheFree text: It's a sinus headache from my CPAPMedDRA releases: 2024-11 · check-in free text available
- 2022-10-14
-
2022-10-15
Health check-in — days 1–6 daily, dose 5Feeling: Good · None · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-16
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2022-11-21
- 2023-01-09
- 2023-04-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-09 | Moderna | |
| 2 | 2021-04-07 | Moderna | |
| 3 | 2021-10-25 | Moderna | Flu |
| 4 | 2022-05-07 | Moderna | No |
| 5 | 2022-10-10 | Moderna | Flu |
Call center
2 call center cases
2 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Im T 2 diabetic with arthritis so my response to this is nothing new
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Hypoglycemic episode at 0530 hrs
Systemic reaction (other): Joint pain is in my jaw and teeth on the left side
Systemic reaction (other): I had a hypoglycemic incident this morning
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I was hypoglycemic at 0330 hrs still recovering
Release 10 — day 7, dose 3
Systemic reaction (other): I have moderate arthritis in both my knees
Release 10 — day 21, dose 3
Symptoms: My arthritis is acting up a little bit and I was sneezing so I assume it's from dust allergies
Release 11 — 6 months, dose 3
Symptoms: pneumonia
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): It's a sinus headache from my CPAP
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 | Arthritis | · | · | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Arthritis | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Hypoglycaemia | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Positive airway pressure therapy | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Sinus headache | · | · | ✓ |
| SRO | Toothache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release