49E-10090-62792
5 vaccinations
6 coded responses
63 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 146 / NY
- Registered
- 2021-03-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-01
Registered in v-safe
-
2021-03-01
Dose 1 — Moderna
- 2021-03-01
-
2021-03-02
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: Muscle ache only at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
-
2021-03-08
Survey response — day 7, dose 1MedDRA: Injection site rash — Feeling: Good · Site: Redness, Swelling, ItchingFree text: Minor rash appeared 7 days after dose 1. It's localized at injection site, in area 2-3 in sq.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-15
- 2021-03-22
-
2021-03-29
Dose 2 — Moderna
- 2021-03-29
-
2021-03-30
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection siteFree text: Faint rash at back of waist, left and right.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: Rash at back of waist to left & right is mild.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-01
Survey response — days 1–6 daily, dose 2MedDRA: Injection site rash, Rash — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: Rash at injection site, and back of waist not as red or itchy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-27
- 2021-05-03
- 2021-05-11
- 2021-06-28
- 2021-09-27
-
2021-11-05
Dose 3 — Moderna
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-09
- 2021-11-11
- 2021-11-12
- 2021-11-21
- 2021-11-26
- 2021-12-04
- 2021-12-10
- 2021-12-17
- 2022-02-04
- 2022-05-07
-
2022-05-20
Dose 4 — Moderna
- 2022-05-20
- 2022-05-21
- 2022-05-22
- 2022-05-23
- 2022-05-25
- 2022-05-26
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-01
-
2022-08-21
Survey response — 3 months, dose 4MedDRA: Cough, Lymphadenopathy, Office visit, Oropharyngeal pain, Productive cough, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Persistent scratchy, mildly sore throat. A little swelling at neck glands. Sometime dry cough, or with a little clear phlegm. · Healthcare visit (other): Primary Care Physician - in officeMedDRA releases: 2024-11 · check-in free text available
-
2022-08-21
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-08-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-18
-
2022-12-07
Dose 5 — Moderna
- 2022-12-11
- 2022-12-13
- 2022-12-14
- 2022-12-21
- 2022-12-28
- 2023-01-04
- 2023-01-11
- 2023-01-18
- 2023-03-08
- 2023-06-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-01 | Moderna | |
| 2 | 2021-03-29 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-05-20 | Moderna | No |
| 5 | 2022-12-07 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Muscle ache only at injection site.
Release 5 — day 7, dose 1
Systemic reaction (other): Minor rash appeared 7 days after dose 1. It's localized at injection site, in area 2-3 in sq.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Faint rash at back of waist, left and right.
Systemic reaction (other): Rash at back of waist to left & right is mild.
Systemic reaction (other): Rash at injection site, and back of waist not as red or itchy.
Release 12 — 3 months, dose 4
Symptoms: Persistent scratchy, mildly sore throat. A little swelling at neck glands. Sometime dry cough, or with a little clear phlegm.
Healthcare visit (other): Primary Care Physician - in office
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Lymphadenopathy | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release