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4HH-78349-30454

1 vaccination 5 coded responses 10 check-ins 5 free-text entries 0 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
457 / OH
Registered
2021-02-14
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-13
    Dose 1 — Moderna
  2. 2021-02-14
    Registered in v-safe
  3. 2021-02-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthralgia, Myalgia, Pain in extremity — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: My right shoulder very sore,finger joints hurts,neck mussells hurt on both sides
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-02-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Itching · Headache
    Adult check-in
  6. 2021-02-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-19
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pruritus — Feeling: Good · Site: Itching
    Free text: Inching comes one day the next day nothing then comes back again, iam not sure what to exspeck from this 2nd shot and if this is going to a problem all of the time? If you all have answers i sure would like to know
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-20
    Survey response — day 7, dose 1
    MedDRA: Haemorrhage, Injection site haemorrhage, Injection site pruritus, Pruritus — Feeling: Good · Site: Itching
    Free text: Where shot was given that area itches, the hole where needle went in has not healed, bleeds
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-27
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-03-07
    Survey response — day 21, dose 1
    MedDRA: Injection site rash — Feeling: Good
    Free text: Rash around injection site, used anti byatic sauve slowly went away
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-05-15
    Survey response — 3 months, dose 1
    MedDRA: Adverse reaction, Erythema — Feeling: Good
    Free text: Breaking out on my arms, back, chest, real small pipples that turn red
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2022-02-15
    Health check-in — 12 months, dose 1
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-13Moderna

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-14

Systemic reaction (other): My right shoulder very sore,finger joints hurts,neck mussells hurt on both sides

2021-02-19

Systemic reaction (other): Inching comes one day the next day nothing then comes back again, iam not sure what to exspeck from this 2nd shot and if this is going to a problem all of the time? If you all have answers i sure would like to know

Release 4 — day 7, dose 1

2021-02-20

Systemic reaction (other): Where shot was given that area itches, the hole where needle went in has not healed, bleeds

Release 5 — day 21, dose 1

2021-03-07

Symptoms: Rash around injection site, used anti byatic sauve slowly went away

Release 8 — 3 months, dose 1

2021-05-15

Symptoms: Breaking out on my arms, back, chest, real small pipples that turn red

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
SDAdverse reaction ✓ ✓ ✓
SDErythema ✓ ✓ ✓
SDInjection site rash ✓ ✓ ✓
SROArthralgia ✓ ✓ ✓
SROHaemorrhage ○ ✓ ○
SROInjection site haemorrhage ✓ · ✓
SROInjection site pruritus ✓ · ✓
SROMyalgia ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPruritus ✓ ✓ ✓

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