4G6-28490-19926
5 vaccinations
19 coded responses
64 check-ins
17 free-text entries
4 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 982 / WA
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-30
Registered in v-safe
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2021-01-30
Dose 1 — Moderna
- 2021-01-30
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2021-01-31
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: The pain at the injection site may be too minor even to call "pain" it's exactly like almost every other vaccine I've ever been given.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-13
- 2021-02-20
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2021-02-27
Dose 2 — Moderna
- 2021-02-27
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2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal distension — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Feeling bloatedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
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2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Night sweats — Feeling: Good · Site: PainFree text: heavy night sweats past two nightsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-13
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2021-03-20
Survey response — day 21, dose 2MedDRA: Diarrhoea — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesFree text: violent diarrhea Monday-Wednesday, no idea if it had anything to do with my vaccinationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-27
- 2021-04-03
- 2021-04-10
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2021-05-29
Survey response — 3 months, dose 2MedDRA: Diarrhoea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: GI trouble. Diarrhea, virtually unceasing varietyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-28
Survey response — 6 months, dose 2MedDRA: Blood blister, Nail disorder, Nail ridging, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I had some blood blisters (or reasonable facsimiles) break out on my legs and genitals, not many of them but very bright red, and after a few days they went away. Also, my thumbnail is doing something strange, ridges, stripes and nail sloughing off. · Healthcare visit (other): visit with my PCPMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-28
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-10-27
Dose 3 — Moderna
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2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Fatigue or tiredness, Abdominal painAdult check-in
- 2021-10-31
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2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Abdominal pain upper, Epigastric discomfort, Self-medication — Feeling: GoodFree text: Some gastric discomfort, but that may be from the Imodium I took yesterday to stop the stomach crampingMedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Night sweats — Feeling: Good · Fatigue or tirednessFree text: night sweats, possibly unrelatedMedDRA releases: 2024-11 · check-in free text available
- 2021-11-03
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
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2021-12-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-01-26
Survey response — 3 months, dose 3MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Not Covid-related · Healthcare visit (other): Orthopedic evaluation scheduledMedDRA releases: 2024-11 · check-in free text available
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2022-01-26
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-01-28
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2022-04-04
Dose 4 — Moderna
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2022-04-07
Survey response — days 1–6 daily, dose 4MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Rash, not including the immediate area around the injection siteFree text: You're asking about today and I'm better, but the last two days were bad, worse than after any of the other shotsMedDRA releases: 2024-11 · check-in free text available
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2022-04-08
Survey response — days 1–6 daily, dose 4MedDRA: Immunisation reaction — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: I've never experienced anything like this after my previous shots. This reaction was much more severe.MedDRA releases: 2024-11 · check-in free text available
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2022-04-09
Survey response — days 1–6 daily, dose 4MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: The rash seems to be going awayMedDRA releases: 2024-11 · check-in free text available
- 2022-04-10
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2022-04-11
Survey response — day 7, dose 4MedDRA: Haemorrhage, Rash pustular — Feeling: GoodFree text: Weirdly enough one of those rash pustules (or whatever they were) which I thought were fading just burst out into a bleed when I got out of the shower last eveningMedDRA releases: 2024-11 · check-in free text available
- 2022-04-18
- 2022-04-25
- 2022-05-02
- 2022-05-09
- 2022-05-16
- 2022-07-06
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2022-10-03
Survey response — 6 months, dose 4MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Covid late MayMedDRA releases: 2024-11 · check-in free text available
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2022-10-03
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-10-06
- 2022-10-06
- 2022-10-10
- 2022-10-10
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2022-10-11
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-10-11
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-10-13
Dose 5 — ModernaCo-administered: Pneumonia
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2022-10-14
Health check-in — days 1–6 daily, dose 5Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2022-10-15
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-10-16
Survey response — days 1–6 daily, dose 5MedDRA: Chest pain, Dyspnoea — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesFree text: chest pain, shortness of breathMedDRA releases: 2024-11 · check-in free text available
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2022-10-17
Survey response — days 1–6 daily, dose 5MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea, Diarrhea · Be unable to do your normal daily activitiesFree text: chest/breathingMedDRA releases: 2024-11 · check-in free text available
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2022-10-18
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Nausea, DiarrheaAdult check-in
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2022-10-19
Survey response — days 1–6 daily, dose 5MedDRA: Respiratory tract congestion — Feeling: Fair · Headache, Fatigue or tiredness, DiarrheaFree text: CongestionMedDRA releases: 2024-11 · check-in free text available
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-11-17
- 2022-11-24
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2023-01-12
Survey response — 3 months, dose 5MedDRA: COVID-19 — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
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2023-01-12
Report sent to call center — 3 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-01-13
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2023-04-13
Survey response — 6 months, dose 5MedDRA: Blood bilirubin increased, Fatigue, Insomnia — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna | |
| 2 | 2021-02-27 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-04 | Moderna | No |
| 5 | 2022-10-13 | Moderna | Pneumonia |
Call center
4 call center cases
3 successful · 1 unsuccessful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): The pain at the injection site may be too minor even to call "pain" it's exactly like almost every other vaccine I've ever been given.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Feeling bloated
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): heavy night sweats past two nights
Release 6 — day 21, dose 2
Symptoms: violent diarrhea Monday-Wednesday, no idea if it had anything to do with my vaccination
Release 8 — 3 months, dose 2
Symptoms: GI trouble. Diarrhea, virtually unceasing variety
Release 9 — 6 months, dose 2
Symptoms: I had some blood blisters (or reasonable facsimiles) break out on my legs and genitals, not many of them but very bright red, and after a few days they went away. Also, my thumbnail is doing something strange, ridges, stripes and nail sloughing off. cut off by CDC
Healthcare visit (other): visit with my PCP
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Some gastric discomfort, but that may be from the Imodium I took yesterday to stop the stomach cramping
Systemic reaction (other): night sweats, possibly unrelated
Release 11 — 3 months, dose 3
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): You're asking about today and I'm better, but the last two days were bad, worse than after any of the other shots
Systemic reaction (other): I've never experienced anything like this after my previous shots. This reaction was much more severe.
Systemic reaction (other): The rash seems to be going away
Release 11 — day 7, dose 4
Systemic reaction (other): Weirdly enough one of those rash pustules (or whatever they were) which I thought were fading just burst out into a bleed when I got out of the shower last evening
Release 12 — 6 months, dose 4
Symptoms: Covid late May
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): chest pain, shortness of breath
Systemic reaction (other): chest/breathing
Systemic reaction (other): Congestion
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 | Office visit | ✓ | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Blood bilirubin increased | · | · | ✓ |
| SD | Blood blister | ✓ | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Nail disorder | ✓ | · | ✓ |
| SD | Nail ridging | ✓ | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Abdominal distension | ✓ | ✓ | ✓ |
| SRO | Abdominal pain upper | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Chest pain | · | · | ✓ |
| SRO | Dyspnoea | · | · | ✓ |
| SRO | Epigastric discomfort | · | · | ✓ |
| SRO | Haemorrhage | · | · | ✓ |
| SRO | Immunisation reaction | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Rash pustular | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release