4DR-33415-34010
4 vaccinations
13 coded responses
39 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 222 / VA
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-02
Registered in v-safe
-
2021-03-02
Dose 1 — Moderna
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
-
2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Just an FYI : my brother and sister which we are roughly same age, we got three different vaccine so it will be interesting to see the results down the road.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
-
2021-03-09
Survey response — day 7, dose 1MedDRA: Abdominal distension — Feeling: GoodFree text: Feel Bloated for couple of day , nothing major.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — day 14, dose 1MedDRA: Asthenia, Headache, Somnolence — Feeling: Fair · Be unable to do your normal daily activitiesFree text: My head was very cloudy( groggy) for few days. Slight headaches here and there but over all I was not myself, lack of energy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
-
2021-03-30
Dose 2 — Moderna
-
2021-03-30
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: GoodFree text: Nothing yet as it has been only 6 hours since I got the shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Flatulence — Feeling: Fair · Fatigue or tirednessFree text: Lots of stomach gasMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
-
2021-04-06
Survey response — day 7, dose 2MedDRA: Gastrointestinal disorder — Feeling: GoodFree text: I have had stomach issue last few days but nothing major.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-13
Survey response — day 14, dose 2MedDRA: Asthenia, Gastrointestinal disorder — Feeling: FairFree text: I have had stomach issue, pain here and there and feel a little weak. It is manageable but not perfect.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-06-29
- 2021-09-28
-
2021-11-04
Dose 3 — Moderna
- 2022-03-30
-
2023-02-10
Dose 4 — Moderna
- 2023-02-10
-
2023-02-12
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue, Somnolence — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-02-13
-
2023-02-14
Survey response — days 1–6 daily, dose 4MedDRA: Feeling hot, Hyperhidrosis — Feeling: Fair · Fever · Fatigue or tirednessMedDRA releases: 2024-11
-
2023-02-15
Survey response — days 1–6 daily, dose 4MedDRA: Somnolence — Feeling: Fair · Fatigue or tirednessMedDRA releases: 2024-11
- 2023-02-16
- 2023-02-17
- 2023-02-24
-
2023-03-03
Survey response — day 21, dose 4MedDRA: Blood potassium decreased, Blood sodium decreased, Headache, Hospitalisation, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationMedDRA releases: 2024-11
-
2023-03-03
Report sent to call center — day 21, dose 4Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2023-03-06
- 2023-03-07
-
2023-03-07
Callback requested for09:30AM ET
- 2023-03-10
- 2023-03-17
- 2023-03-24
- 2023-05-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna | |
| 3 | 2021-11-04 | Moderna | No |
| 4 | 2023-02-10 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Just an FYI : my brother and sister which we are roughly same age, we got three different vaccine so it will be interesting to see the results down the road.
Release 5 — day 7, dose 1
Systemic reaction (other): Feel Bloated for couple of day , nothing major.
Release 5 — day 14, dose 1
Symptoms: My head was very cloudy( groggy) for few days. Slight headaches here and there but over all I was not myself, lack of energy.
Release 6 — day 0, dose 2
Systemic reaction (other): Nothing yet as it has been only 6 hours since I got the shot
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Lots of stomach gas
Release 7 — day 7, dose 2
Systemic reaction (other): I have had stomach issue last few days but nothing major.
Release 7 — day 14, dose 2
Symptoms: I have had stomach issue, pain here and there and feel a little weak. It is manageable but not perfect.
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 | Asthenia | ✓ | ✓ | ✓ |
| SD | Blood potassium decreased | · | · | ✓ |
| SD | Blood sodium decreased | · | · | ✓ |
| SD | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Somnolence | ✓ | ✓ | ✓ |
| SRO | Abdominal distension | ✓ | ✓ | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Feeling hot | · | · | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
| SRO | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Somnolence | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release