4GQ-13407-16252
4 vaccinations
2 coded responses
40 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 212 / MD
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Moderna
- 2021-01-14
-
2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-20
- 2021-01-21
-
2021-01-28
Survey response — day 14, dose 1MedDRA: Injection site rash, Rash erythematous, Rash macular, Rash pruritic — Feeling: GoodFree text: On day 7-8, developed a 6 x 8 cm erythematous, mildly pruritic, discrete macular rash at the injection site and appearing to have gravitational migration. Moderately responsive to topical hydrocortisone 1%, and almost resolved at today's check-in.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
- 2021-02-11
-
2021-02-16
Dose 2 — Moderna
-
2021-02-18
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
- 2021-03-11
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-17
-
2021-12-23
Dose 3 — Moderna
- 2022-02-16
- 2022-03-24
- 2022-06-23
-
2022-10-27
Dose 4 — Moderna
- 2022-10-27
-
2022-10-28
Survey response — days 1–6 daily, dose 4MedDRA: Chills, Hyperhidrosis, Injection site pain, Poor quality sleep, Pyrexia, Sleep disorder — Feeling: Fair · Site: Pain, Redness, Swelling · FeverFree text: Restless sleep because of moderate injection site pain (too painful to lay on that side), ~15-20 min period of real chills (very early am), then mild fever-associated symptoms until resolving by morning with a mild sweatMedDRA releases: 2024-11 · check-in free text available
- 2022-10-30
- 2022-10-31
- 2022-11-01
- 2022-11-02
- 2022-11-03
- 2022-11-10
- 2022-11-17
- 2022-11-24
- 2022-12-01
- 2022-12-08
- 2023-01-28
- 2023-04-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-12-23 | Moderna | No |
| 4 | 2022-10-27 | Moderna | No |
Free text
Release 2 — day 14, dose 1
Symptoms: On day 7-8, developed a 6 x 8 cm erythematous, mildly pruritic, discrete macular rash at the injection site and appearing to have gravitational migration. Moderately responsive to topical hydrocortisone 1%, and almost resolved at today's check-in.
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Restless sleep because of moderate injection site pain (too painful to lay on that side), ~15-20 min period of real chills (very early am), then mild fever-associated symptoms until resolving by morning with a mild sweat
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 | Injection site rash | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Rash macular | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Hyperhidrosis | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Poor quality sleep | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Sleep disorder | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release