4BD-12083-04372
4 vaccinations
8 coded responses
50 check-ins
8 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 985 / WA
- Registered
- 2021-01-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Dose 1 — Moderna
-
2021-01-24
Registered in v-safe
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-02-04
- 2021-02-11
-
2021-02-18
Dose 2 — Moderna
- 2021-02-18
-
2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Pain — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: AchyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-20
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: Good · Muscle or body achesFree text: L shoulder (injection) achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Myalgia — Feeling: Good · Site: Pain · Muscle or body achesFree text: L deltoid still a little soreMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-22
- 2021-02-23
-
2021-02-24
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
-
2021-05-20
Survey response — 3 months, dose 2MedDRA: Arthralgia — Feeling: GoodFree text: Both shoulders hurt. But I think its from over stretching the rotator cuff.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-19
Survey response — 6 months, dose 2MedDRA: Arthralgia, Myalgia — Feeling: GoodFree text: Joints snd muscles ache most of the timeMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-26
Dose 3 — Moderna
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
- 2021-10-30
- 2021-10-31
- 2021-11-01
-
2021-11-02
Survey response — day 7, dose 3MedDRA: Injection site bruising — Feeling: GoodFree text: Still have large purple/yellow bruise at injection siteMedDRA releases: 2024-11 · check-in free text available
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2021-11-09
Survey response — day 14, dose 3MedDRA: Peripheral swelling, Synovial cyst, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Baker's cyst left leg causing below knee swelling. Prob not related to shot at all. · Healthcare visit (other): Ultra sound of left legMedDRA releases: 2024-11 · check-in free text available
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2021-11-09
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-11-11
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
-
2022-01-25
Survey response — 3 months, dose 3MedDRA: Cyst drainage, Peripheral swelling, Synovial cyst — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Swelling of L. Leg below knee due to lg Bakers cyst which was drained Friday 01/21 and received cortisone shot. Swelling has diminished greatly. Leg near normal size now.MedDRA releases: 2024-11 · check-in free text available
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2022-01-25
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
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2022-01-26
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-04-14
Dose 4 — Moderna
- 2022-04-15
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-19
- 2022-05-26
- 2022-07-15
- 2022-10-13
- 2023-04-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-18 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-04-14 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Achy
Systemic reaction (other): L shoulder (injection) aches
Systemic reaction (other): L deltoid still a little sore
Release 8 — 3 months, dose 2
Symptoms: Both shoulders hurt. But I think its from over stretching the rotator cuff.
Release 9 — 6 months, dose 2
Symptoms: Joints snd muscles ache most of the time
Release 10 — day 7, dose 3
Systemic reaction (other): Still have large purple/yellow bruise at injection site
Release 10 — day 14, dose 3
Symptoms: Baker's cyst left leg causing below knee swelling. Prob not related to shot at all.
Healthcare visit (other): Ultra sound of left leg
Release 11 — 3 months, dose 3
Symptoms: Swelling of L. Leg below knee due to lg Bakers cyst which was drained Friday 01/21 and received cortisone shot. Swelling has diminished greatly. Leg near normal size now.
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 | Unevaluable event | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Cyst drainage | · | · | ✓ |
| SD | Myalgia | ✓ | · | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Synovial cyst | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | · | · | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release