4FT-22870-62507
2 vaccinations
5 coded responses
22 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 196 / PA
- Registered
- 2021-04-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-27
Dose 1 — Moderna
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2021-04-28
Registered in v-safe
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2021-04-28
Survey response — days 1–6 daily, dose 1MedDRA: Tinnitus — Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Ringing in the earsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-29
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue, Pain, Tinnitus — Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Ringing in the ears- off and on. Just like the other symptoms, they come and go in waves. It hits and i feel completely exhausted and achey all over. 10 - 15 minutes it goes away and comes back within 30 - 45 minutesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-30
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal pain — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Abdominal pain was like cramping, very intense. Omly ate a banana rhis morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-01
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
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2021-05-02
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-03
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-04
Health check-in — day 7, dose 1Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-11
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2021-05-18
Survey response — day 21, dose 1MedDRA: Ear pain, Pain in jaw, Sinusitis — Feeling: GoodFree text: I have a sinus infection that is causing pain in my left ear down around my jaw bone to my glandMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-25
Dose 2 — Moderna
- 2021-05-25
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2021-05-26
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to workAdult check-in
- 2021-05-28
- 2021-05-29
- 2021-05-30
- 2021-05-31
- 2021-06-01
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2021-06-08
Survey response — day 14, dose 2MedDRA: Asthenia, Back pain, Headache, Musculoskeletal stiffness, Nausea, Pain in extremity — Feeling: Good · Be unable to workFree text: At 7 days after my 2nd shot, i experienced leg, back, and neck stiffness and sorenwss. Weakness in my entire body. Nausea, headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-15
- 2021-06-22
- 2021-06-29
- 2021-08-24
- 2021-11-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-27 | Moderna | |
| 2 | 2021-05-25 | Moderna |
Free text
Release 8 — days 1–6 daily, dose 1
Systemic reaction (other): Ringing in the ears
Systemic reaction (other): Ringing in the ears- off and on. Just like the other symptoms, they come and go in waves. It hits and i feel completely exhausted and achey all over. 10 - 15 minutes it goes away and comes back within 30 - 45 minutes
Systemic reaction (other): Abdominal pain was like cramping, very intense. Omly ate a banana rhis morning.
Release 8 — day 21, dose 1
Symptoms: I have a sinus infection that is causing pain in my left ear down around my jaw bone to my gland
Release 8 — day 14, dose 2
Symptoms: At 7 days after my 2nd shot, i experienced leg, back, and neck stiffness and sorenwss. Weakness in my entire body. Nausea, headache.
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 | Back pain | ✓ | ✓ | ✓ |
| SD | Ear pain | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pain in jaw | ✓ | ✓ | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release