47Z-30719-11930
2 vaccinations
6 coded responses
15 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 051 / VT
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-08
Dose 1 — Moderna
-
2021-04-07
Dose 2 — Moderna
-
2021-04-08
Registered in v-safe
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2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-04-09
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2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Small bumpy rash showed up on my left upper chest where arm meets the shoulderMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: GoodFree text: I just found myself physically exhausted all of a sudden about 15 minutes ago. Like ready for bed and its only 7:30 not sure if its related or just coincidenceMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Discomfort, Dry throat, Neck pain, Oropharyngeal pain — Feeling: GoodFree text: I had some minor pain in my neck and a slight feeling of sore throat or dry throat this morning lymph nodes sensitive to pressure no swelling and it seems to have passedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-13
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2021-04-14
Survey response — day 7, dose 2MedDRA: Cough — Feeling: GoodFree text: Coughing fit overnight possibly related to spring allergies not a dry coughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-07-07
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2021-10-06
Survey response — 6 months, dose 2MedDRA: Eye irritation, Pre-existing disease, Sneezing — Feeling: FairFree text: Sneezing burning eyes allergiesMedDRA releases: 2024-11 · check-in free text available
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2022-04-09
Survey response — 12 months, dose 2MedDRA: Dyspnoea — Feeling: FairFree text: Shortness of breath using inhaler moreMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-08 | Moderna | |
| 2 | 2021-04-07 | Moderna |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Small bumpy rash showed up on my left upper chest where arm meets the shoulder
Systemic reaction (other): I just found myself physically exhausted all of a sudden about 15 minutes ago. Like ready for bed and its only 7:30 not sure if its related or just coincidence
Systemic reaction (other): I had some minor pain in my neck and a slight feeling of sore throat or dry throat this morning lymph nodes sensitive to pressure no swelling and it seems to have passed
Release 7 — day 7, dose 2
Systemic reaction (other): Coughing fit overnight possibly related to spring allergies not a dry cough
Release 10 — 6 months, dose 2
Symptoms: Sneezing burning eyes allergies
Release 11 — 12 months, dose 2
Symptoms: Shortness of breath using inhaler more
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 | Dyspnoea | · | · | ✓ |
| SD | Eye irritation | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Dry throat | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release