49M-28374-10966
2 vaccinations
2 coded responses
18 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 989 / WA
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Moderna
- 2021-01-12
-
2021-01-13
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: If I press on the injection site it feels like pushing on a bruise. Not exactly what I consider pain just like a one inch bruise.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-16
- 2021-01-19
- 2021-01-26
- 2021-02-03
-
2021-02-09
Dose 2 — Moderna
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Headache, Nausea, Pain, Pyrexia, Self-medication — Feeling: Good · Site: Pain · HeadacheFree text: I put no symptoms today but the night of and all the next day I had a 102+ fever, severe chills, headache, nausea, arm and body pain. About 30 hours after shot I took two aspirin then in half an hour I took two Tylenol. In about an hour my fever broke pains and all other symptoms went away in a few hours and today I am 100% normal again.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-16
- 2021-02-25
- 2021-03-07
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-05-11
- 2022-02-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-09 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): If I press on the injection site it feels like pushing on a bruise. Not exactly what I consider pain just like a one inch bruise.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): I put no symptoms today but the night of and all the next day I had a 102+ fever, severe chills, headache, nausea, arm and body pain. About 30 hours after shot I took two aspirin then in half an hour I took two Tylenol. In about an hour my fever broke pains and all other symptoms went away in a few hours and today I am 100% normal again.
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 | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ○ | ○ | ○ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release