42K-38236-69821
5 vaccinations
11 coded responses
53 check-ins
11 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 921 / CA
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
NVX-23305-30880
Adult relative or friend · Female · 2021-12-28
Timeline
-
2021-01-26
Dose 1 — Moderna
-
2021-02-11
Registered in v-safe
- 2021-02-11
- 2021-02-16
-
2021-02-23
Dose 2 — Moderna
- 2021-02-23
-
2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Sinus congestion — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessFree text: Sinus stoppage- left side - side of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-02-26
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Nasal congestion, Nasopharyngitis, Pre-existing disease, Sinus congestion — Feeling: Fair · Site: PainFree text: Sinus stuffyness like common cold or allergiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Nasal congestion — Feeling: FairFree text: Stuffed nose on injection side of bodyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-25
- 2021-03-30
- 2021-04-06
- 2021-05-25
-
2021-10-29
Dose 3 — Moderna
-
2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
-
2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body achesAdult check-in
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-11-04
- 2021-11-07
- 2021-11-15
- 2021-11-19
- 2021-11-26
-
2021-12-10
Survey response — day 42, dose 3MedDRA: Gastrointestinal disorder — Feeling: FairFree text: Stomach - intestinal issuesMedDRA releases: 2024-11 · check-in free text available
- 2022-01-28
-
2022-03-30
Dose 4 — Pfizer-BioNTech
- 2022-03-31
- 2022-04-01
- 2022-04-02
- 2022-04-03
-
2022-04-04
Health check-in — days 1–6 daily, dose 4Feeling: Good · Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
-
2022-04-05
Health check-in — days 1–6 daily, dose 4Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-04-06
- 2022-04-13
- 2022-04-20
-
2022-04-27
Survey response — day 28, dose 4MedDRA: Ear pain — Feeling: FairFree text: Rt ear pain for past week.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-04
Survey response — day 35, dose 4MedDRA: Sinus disorder — Feeling: GoodFree text: Sinus issuesMedDRA releases: 2024-11 · check-in free text available
- 2022-05-13
-
2022-06-29
Survey response — 3 months, dose 4MedDRA: Back pain — Feeling: FairFree text: Lower back pain issuesMedDRA releases: 2024-11 · check-in free text available
-
2022-09-16
Dose 5 — Pfizer-BioNTech
- 2022-09-16
-
2022-09-17
Survey response — days 1–6 daily, dose 5MedDRA: Skin discolouration — Feeling: Fair · Diarrhea, Abdominal painFree text: Black and blue splotches on injection arm, not immediately around injection site.MedDRA releases: 2024-11 · check-in free text available
- 2022-09-18
- 2022-09-19
- 2022-09-20
-
2022-09-21
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Headache, Fatigue or tiredness, Abdominal painAdult check-in
- 2022-09-22
- 2022-09-23
- 2022-10-01
- 2022-10-09
-
2022-10-16
Survey response — day 28, dose 5MedDRA: Contusion, Haemorrhage, Skin laceration — Feeling: FairFree text: Bruising - bleeding from contact points, tears of skinMedDRA releases: 2024-11 · check-in free text available
-
2022-10-23
Survey response — day 35, dose 5MedDRA: Cough, Pre-existing disease, Rhinorrhoea, Sinus disorder — Feeling: FairFree text: Sunus / allergies & nasal drainage / frequent coughsMedDRA releases: 2024-11 · check-in free text available
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2022-12-16
Survey response — 3 months, dose 5MedDRA: Ear congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Extreme congestion in my right eardrumMedDRA releases: 2024-11 · check-in free text available
-
2022-12-16
Report sent to call center — 3 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-21
- 2023-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-23 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-03-30 | Pfizer-BioNTech | No |
| 5 | 2022-09-16 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Sinus stoppage- left side - side of injection
Systemic reaction (other): Sinus stuffyness like common cold or allergies
Systemic reaction (other): Stuffed nose on injection side of body
Release 10 — day 42, dose 3
Symptoms: Stomach - intestinal issues
Release 11 — day 28, dose 4
Symptoms: Rt ear pain for past week.
Release 11 — day 35, dose 4
Symptoms: Sinus issues
Release 12 — 3 months, dose 4
Symptoms: Lower back pain issues
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Black and blue splotches on injection arm, not immediately around injection site.
Release 12 — day 28, dose 5
Symptoms: Bruising - bleeding from contact points, tears of skin
Release 12 — day 35, dose 5
Symptoms: Sunus / allergies & nasal drainage / frequent coughs
Release 12 — 3 months, dose 5
Symptoms: Extreme congestion in my right eardrum
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 | Back pain | · | · | ✓ |
| SD | Contusion | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Ear congestion | · | · | ✓ |
| SD | Ear pain | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Haemorrhage | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sinus disorder | · | · | ✓ |
| SD | Skin laceration | · | · | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Nasopharyngitis | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Sinus congestion | ✓ | ✓ | ✓ |
| SRO | Skin discolouration | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release