4EE-72435-52787
5 vaccinations
6 coded responses
42 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 480 / MI
- Registered
- 2021-03-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-23
Dose 1 — Moderna
-
2021-03-27
Registered in v-safe
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-04-01
- 2021-04-06
- 2021-04-13
-
2021-04-20
Dose 2 — Moderna
- 2021-04-20
- 2021-04-21
-
2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Arm pain location of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-05-04
- 2021-05-11
-
2021-05-18
Survey response — day 28, dose 2MedDRA: Dizziness — Feeling: FairFree text: Light headed and Swimmy headed, dizzy for a couple daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-25
- 2021-06-01
- 2021-07-20
- 2021-10-19
-
2021-10-29
Dose 3 — Moderna
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Respiratory tract congestion — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Cough stuffy headMedDRA releases: 2024-11 · check-in free text available
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Proctalgia — Feeling: Good · Joint pains, Muscle or body achesFree text: Pain inside my rectumMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2022-01-28
- 2022-04-29
-
2022-06-17
Dose 4 — Moderna
- 2022-06-26
- 2022-07-01
- 2022-07-08
- 2022-07-15
- 2022-07-22
- 2022-07-31
-
2022-09-16
Survey response — 3 months, dose 4MedDRA: Exposure to SARS-CoV-2, SARS-CoV-2 test negative, Secretion discharge, Sinus congestion — Feeling: GoodFree text: My wife got Covid and after about 10 days she was good but then very shortly after she got a lotta mucus sinus congestion and then I got it the mucus in the sinus congestion but no Covid I don't know if any of that was related to Covid but it was strMedDRA releases: 2024-11 · check-in free text available
-
2022-10-16
Dose 5 — Moderna
-
2022-12-16
Survey response — 6 months, dose 4MedDRA: Ear infection, Urinary tract infection — Feeling: PoorFree text: Ear infection, UTI that I can't get rid ofMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-23 | Moderna | |
| 2 | 2021-04-20 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-06-17 | Moderna | No |
| 5 | 2022-10-16 | Moderna | No |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Arm pain location of injection
Release 8 — day 28, dose 2
Symptoms: Light headed and Swimmy headed, dizzy for a couple days
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Cough stuffy head
Systemic reaction (other): Pain inside my rectum
Release 12 — 3 months, dose 4
Symptoms: My wife got Covid and after about 10 days she was good but then very shortly after she got a lotta mucus sinus congestion and then I got it the mucus in the sinus congestion but no Covid I don't know if any of that was related to Covid but it was str cut off by CDC
Release 12 — 6 months, dose 4
Symptoms: Ear infection, UTI that I can't get rid of
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 | Dizziness | ✓ | ✓ | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Secretion discharge | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Proctalgia | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release