3YG-15327-65516
1 vaccination
6 coded responses
7 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 228 / VA
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Registered in v-safe
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2021-03-11
Dose 1 — Moderna
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2021-03-11
Survey response — day 0, dose 1MedDRA: Hyperventilation, Immediate post-injection reaction, Respiratory rate decreased — Feeling: GoodFree text: 5 minutes after receiving the injection I experienced very deep breathing and a much slower respiration rate. These symptoms lasted about 5 minutes. I did not feel distressed during this time. Then my breathing suddenly became restored to normalMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Myalgia, Self-medication — Feeling: Good · Joint painsFree text: Joint and muscle pain in left knee, where I had a total knee replacement in 2010. Taking Tylenol. That helpsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-13
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Fatigue, Pre-existing disease — Feeling: Good · Joint painsFree text: Joint pain, left knee (TKR) has diminished considerably since yesterday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia — Feeling: Good · Joint painsFree text: Joint pain at left knee (TKR) has diminished back to normal levels, as when before I received the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Condition aggravated, Knee arthroplasty — Feeling: Good · Joint painsFree text: Joint pains, left knee TKR but the pain now is no worse than before receiving the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Joint painsFree text: Joint pains are now same as before I received the injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-09-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): 5 minutes after receiving the injection I experienced very deep breathing and a much slower respiration rate. These symptoms lasted about 5 minutes. I did not feel distressed during this time. Then my breathing suddenly became restored to normal
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Joint and muscle pain in left knee, where I had a total knee replacement in 2010. Taking Tylenol. That helps
Systemic reaction (other): Joint pain, left knee (TKR) has diminished considerably since yesterday.
Systemic reaction (other): Joint pain at left knee (TKR) has diminished back to normal levels, as when before I received the vaccine.
Systemic reaction (other): Joint pains, left knee TKR but the pain now is no worse than before receiving the vaccine
Systemic reaction (other): Joint pains are now same as before I received the injection
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 |
|---|---|---|---|---|
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Fatigue | ○ | ✓ | ○ |
| SRO | Hyperventilation | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Knee arthroplasty | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Respiratory rate decreased | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release