4D4-27405-77884
5 vaccinations
3 coded responses
46 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 970 / OR
- Registered
- 2021-03-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-07
Dose 1 — Moderna
-
2021-03-12
Registered in v-safe
-
2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Cough, Fatigue, Self-medication — Feeling: Fair · Headache, Fatigue or tirednessFree text: Feeling better today then yesterday. Yesterday and evening before I had chills and low grade fever. (99.6). Took Tylenol once yesterday which helped. Also tifdayvand last couple of days have been coughing a bit but not constantly. If I relax, I dont. Health impact report on next page questions are for today. Yesterday, I was more fatigued and couldnt do as much as today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Survey response — days 1–6 daily, dose 1MedDRA: Cough — Feeling: Fair · Fatigue or tirednessFree text: Occasional coughing stillMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-14
Survey response — day 7, dose 1MedDRA: Cough — Feeling: FairFree text: Still some coughing. Not as much though.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
- 2021-03-28
-
2021-04-04
Dose 2 — Moderna
- 2021-04-04
-
2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Fatigue or tirednessAdult check-in
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-18
- 2021-04-25
- 2021-05-02
- 2021-05-09
- 2021-05-16
- 2021-07-04
- 2021-10-03
-
2021-11-15
Dose 3 — Moderna
- 2022-04-04
-
2022-07-11
Dose 4 — Moderna
- 2022-07-14
- 2022-07-15
- 2022-07-16
- 2022-07-17
- 2022-07-20
- 2022-07-25
- 2022-08-01
- 2022-08-08
- 2022-08-15
- 2022-08-22
- 2022-10-10
-
2022-10-20
Dose 5 — Moderna
-
2022-10-21
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
-
2022-10-22
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-10-23
- 2022-10-24
- 2022-10-25
- 2022-10-26
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-11-17
- 2022-11-24
- 2022-12-01
- 2023-01-19
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-07 | Moderna | |
| 2 | 2021-04-04 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-07-11 | Moderna | No |
| 5 | 2022-10-20 | Moderna | No |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Feeling better today then yesterday. Yesterday and evening before I had chills and low grade fever. (99.6). Took Tylenol once yesterday which helped. Also tifdayvand last couple of days have been coughing a bit but not constantly. If I relax, I dont. Health impact report on next page questions are for today. Yesterday, I was more fatigued and couldnt do as much as today.
Systemic reaction (other): Occasional coughing still
Release 5 — day 7, dose 1
Systemic reaction (other): Still some coughing. Not as much though.
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 | Cough | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release