4HB-19113-35421
5 vaccinations
14 coded responses
62 check-ins
13 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 752 / TX
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-31
Registered in v-safe
-
2020-12-31
Dose 1 — Moderna
-
2020-12-31
Survey response — day 0, dose 1MedDRA: Contusion — Feeling: GoodFree text: Slight bruisingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-01
- 2021-01-02
-
2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising — Feeling: GoodFree text: Still some bruising at the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-05
- 2021-01-06
-
2021-01-07
Survey response — day 7, dose 1MedDRA: Muscle spasms — Feeling: GoodFree text: Muscle cramps likely unrelated to the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-16
- 2021-01-21
-
2021-01-28
Dose 2 — Moderna
-
2021-01-28
Survey response — day 0, dose 2MedDRA: Flushing — Feeling: FairFree text: Felt a little flushed otherwise no issues to reportMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · HeadacheAdult check-in
-
2021-01-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Muscle or body achesAdult check-in
-
2021-02-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
- 2021-02-02
-
2021-02-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness · Abdominal painAdult check-in
- 2021-02-04
- 2021-02-13
- 2021-02-18
-
2021-02-25
Survey response — day 28, dose 2MedDRA: Diarrhoea, Flatulence — Feeling: FairFree text: Loose stool and some gas likely unrelated to vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-11
- 2021-05-01
- 2021-07-29
-
2021-09-03
Dose 3 — Moderna
- 2021-09-03
-
2021-09-04
Survey response — days 1–6 daily, dose 3MedDRA: Pain in extremity — Feeling: Fair · Site: SwellingFree text: Soreness in the armMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Swelling · NoneAdult check-in
- 2021-09-07
- 2021-09-12
- 2021-09-17
- 2021-09-26
- 2021-10-01
- 2021-10-10
- 2021-10-17
- 2021-12-05
- 2022-03-06
-
2022-05-20
Dose 4 — Moderna
-
2022-05-20
Survey response — day 0, dose 4MedDRA: Pruritus — Feeling: GoodFree text: Slight itching that might be coincidentalMedDRA releases: 2024-11 · check-in free text available
-
2022-05-21
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body achesAdult check-in
- 2022-05-22
-
2022-05-23
Survey response — days 1–6 daily, dose 4MedDRA: Injection site bruising — Feeling: Good · Site: RednessFree text: A little bruising at the site of the injectionMedDRA releases: 2024-11 · check-in free text available
-
2022-05-24
Survey response — days 1–6 daily, dose 4MedDRA: Injection site bruising — Feeling: Good · Site: RednessFree text: Bruising at the injection siteMedDRA releases: 2024-11 · check-in free text available
-
2022-05-25
Survey response — days 1–6 daily, dose 4MedDRA: Injection site bruising — Feeling: Good · Site: RednessFree text: Some bruising at the injection siteMedDRA releases: 2024-11 · check-in free text available
-
2022-05-26
Survey response — days 1–6 daily, dose 4MedDRA: Injection site bruising — Feeling: Good · Site: RednessFree text: Bruising at the injection site which is diminishingMedDRA releases: 2024-11 · check-in free text available
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-03
- 2022-08-21
-
2022-09-21
Dose 5 — Moderna
- 2022-09-21
-
2022-09-24
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Swelling · Muscle or body achesAdult check-in
- 2022-09-25
- 2022-09-26
-
2022-09-27
Survey response — days 1–6 daily, dose 5MedDRA: Injection site bruising — Feeling: GoodFree text: Slight bruising at and below the injection siteMedDRA releases: 2024-11 · check-in free text available
-
2022-09-28
Survey response — day 7, dose 5MedDRA: Injection site bruising — Feeling: GoodFree text: Slight bruising at injection siteMedDRA releases: 2024-11 · check-in free text available
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-27
- 2022-11-02
- 2022-12-21
-
2023-03-24
Survey response — 6 months, dose 5MedDRA: Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-24
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-03-27
-
2023-03-27
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-31 | Moderna | |
| 2 | 2021-01-28 | Moderna | |
| 3 | 2021-09-03 | Moderna | No |
| 4 | 2022-05-20 | Moderna | No |
| 5 | 2022-09-21 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 1 — day 0, dose 1
Systemic reaction (other): Slight bruising
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Still some bruising at the injection site
Release 1 — day 7, dose 1
Systemic reaction (other): Muscle cramps likely unrelated to the vaccine
Release 3 — day 0, dose 2
Systemic reaction (other): Felt a little flushed otherwise no issues to report
Release 4 — day 28, dose 2
Symptoms: Loose stool and some gas likely unrelated to vaccine
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Soreness in the arm
Release 11 — day 0, dose 4
Systemic reaction (other): Slight itching that might be coincidental
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): A little bruising at the site of the injection
Systemic reaction (other): Bruising at the injection site
Systemic reaction (other): Some bruising at the injection site
Systemic reaction (other): Bruising at the injection site which is diminishing
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Slight bruising at and below the injection site
Release 12 — day 7, dose 5
Systemic reaction (other): Slight bruising at injection site
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 | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Flatulence | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Contusion | ✓ | ✓ | ✓ |
| SRO | Flushing | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | · | ✓ |
| SRO | Pruritus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release