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
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2021-04-29
Dose 1 — Moderna
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2021-05-08
Registered in v-safe
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2021-05-08
Survey response — day 7, dose 1MedDRA: Arthralgia, Induration, Neck mass — Feeling: Good · Joint painsFree text: Hard nodule between right (shot side) clavicle and shoulder, with pain extending into shoulder. 2 days persistentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-13
Survey response — day 14, dose 1MedDRA: Cough, Fatigue, Induration, Nodule, Pain, Sneezing — Feeling: Fair · Be unable to do your normal daily activitiesFree 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
- 2021-05-20
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2021-05-27
Dose 2 — Moderna
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2021-05-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-05-29
Health check-in — days 1–6 daily, dose 2Feeling: 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 siteAdult check-in
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2021-05-30
Survey response — days 1–6 daily, dose 2MedDRA: 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 siteFree text: Loss of taste late night of the 28th, restoring through 29th, seems fully recovered todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
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2021-06-01
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree 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
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2021-06-02
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree 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
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2021-06-03
Survey response — day 7, dose 2MedDRA: Dizziness, Hyperventilation — Feeling: Good · Site: Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Deep breaths still slightly painful, less dizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-17
- 2021-06-24
- 2021-07-01
- 2021-07-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-29 | Moderna | |
| 2 | 2021-05-27 | Moderna |
Free text
Release 8 — day 7, dose 1
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
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
Systemic reaction (other): Loss of taste late night of the 28th, restoring through 29th, seems fully recovered today
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.
Systemic reaction (other): Still get dizzy easily, pain from lungs to lower jaw on deep inhale.
Release 8 — day 7, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Induration | ✓ | ✓ | ✓ |
| SD | Nodule | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SRO | Ageusia | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Hyperventilation | ✓ | ✓ | ✓ |
| SRO | Induration | ✓ | ✓ | ✓ |
| SRO | Neck mass | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Pulmonary pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release