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4GG-16685-67191

2 vaccinations 6 coded responses 14 check-ins 6 free-text entries 0 call cases
Sex
Male
Age at first dose
31-35
ZIP prefix
992 / WA
Registered
2021-05-08
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-29
    Dose 1 — Moderna
  2. 2021-05-08
    Registered in v-safe
  3. 2021-05-08
    Survey response — day 7, dose 1
    MedDRA: Arthralgia, Induration, Neck mass — Feeling: Good · Joint pains
    Free text: Hard nodule between right (shot side) clavicle and shoulder, with pain extending into shoulder. 2 days persistent
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-05-13
    Survey response — day 14, dose 1
    MedDRA: Cough, Fatigue, Induration, Nodule, Pain, Sneezing — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Nodule still in shoulder. Size and hardness same, pain has lessened to only dull ache when prodded. Also have cold (probably unrelated) with fatigue, mild cough, and excessive sneezing.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-05-20
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-05-27
    Dose 2 — Moderna
  7. 2021-05-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  8. 2021-05-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site
    Adult check-in
  9. 2021-05-30
    Survey response — days 1–6 daily, dose 2
    MedDRA: Ageusia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site
    Free text: Loss of taste late night of the 28th, restoring through 29th, seems fully recovered today
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site
    Adult check-in
  11. 2021-06-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chest pain, Dizziness, Dyspnoea — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Free text: Haven't been able to take a deep breath without pain since at least the 30th. Last night tried holding my breath, only lasted 10s before I started blacking out. Today is worse, get dizzy immediately if I stop taking regular breaths or stand up.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-06-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness, Pain in jaw, Pulmonary pain — Feeling: Good · Site: Redness · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Free text: Still get dizzy easily, pain from lungs to lower jaw on deep inhale.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-06-03
    Survey response — day 7, dose 2
    MedDRA: Dizziness, Hyperventilation — Feeling: Good · Site: Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site
    Free text: Deep breaths still slightly painful, less dizziness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-06-17
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-06-24
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-07-01
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-07-08
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-29Moderna
22021-05-27Moderna

Free text

Release 8 — day 7, dose 1

2021-05-08

Systemic reaction (other): Hard nodule between right (shot side) clavicle and shoulder, with pain extending into shoulder. 2 days persistent

Release 8 — day 14, dose 1

2021-05-13

Symptoms: Nodule still in shoulder. Size and hardness same, pain has lessened to only dull ache when prodded. Also have cold (probably unrelated) with fatigue, mild cough, and excessive sneezing.

Release 8 — days 1–6 daily, dose 2

2021-05-30

Systemic reaction (other): Loss of taste late night of the 28th, restoring through 29th, seems fully recovered today

2021-06-01

Systemic reaction (other): Haven't been able to take a deep breath without pain since at least the 30th. Last night tried holding my breath, only lasted 10s before I started blacking out. Today is worse, get dizzy immediately if I stop taking regular breaths or stand up.

2021-06-02

Systemic reaction (other): Still get dizzy easily, pain from lungs to lower jaw on deep inhale.

Release 8 — day 7, dose 2

2021-06-03

Systemic reaction (other): Deep breaths still slightly painful, less dizziness

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

FieldPreferred term2021-092023-042024-11
SDCough ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDInduration ✓ ✓ ✓
SDNodule ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDSneezing ✓ ✓ ✓
SROAgeusia ✓ ✓ ✓
SROArthralgia ✓ ✓ ✓
SROChest pain ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROHyperventilation ✓ ✓ ✓
SROInduration ✓ ✓ ✓
SRONeck mass ✓ ✓ ✓
SROPain in jaw ✓ ✓ ✓
SROPulmonary pain ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release