4HX-30194-75682
2 vaccinations
5 coded responses
19 check-ins
5 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 554 / MN
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Registered in v-safe
-
2021-03-17
Dose 1 — Moderna
- 2021-03-17
- 2021-03-18
-
2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: No I feel normal except my arm is still sore. But better than yesterday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-21
- 2021-03-23
- 2021-03-24
- 2021-03-31
- 2021-04-07
-
2021-04-14
Dose 2 — Moderna
- 2021-04-14
-
2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Emergency care, Syncope — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: I woke up very symptomatic at 230am and fainted. At the ER today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-15
Report sent to call center — days 1–6 daily, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-16
Survey response — days 1–6 daily, dose 2MedDRA: Fall, Myalgia, Syncope — Feeling: Poor · Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesFree text: I have extraordinary muscle aches from my fall from when I fainted the night before last.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-17
Survey response — days 1–6 daily, dose 2MedDRA: Injury, Pain, Syncope — Feeling: Poor · Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesFree text: Body aches from my fall. I wonder if anyone is even looking at these. Moderna shot 2 made me faint and Im lucky I didnt get seriously hurt...MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-19
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
-
2021-04-19
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Fall, Office visit, Pain, Syncope — Feeling: Poor · Muscle or body aches · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Aches from my fall from fainting. · Healthcare visit (other): Massage therapistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-20
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-30
- 2021-05-05
- 2021-05-21
- 2021-07-14
- 2021-11-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-14 | Moderna |
Call center
3 call center cases
3 unsuccessful
1 wait over 3 months for a first call
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): No I feel normal except my arm is still sore. But better than yesterday.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I woke up very symptomatic at 230am and fainted. At the ER today.
Systemic reaction (other): I have extraordinary muscle aches from my fall from when I fainted the night before last.
Systemic reaction (other): Body aches from my fall. I wonder if anyone is even looking at these. Moderna shot 2 made me faint and Im lucky I didnt get seriously hurt...
Systemic reaction (other): Aches from my fall from fainting.
Healthcare visit (other): Massage therapist
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SRO | Emergency care | ✓ | ✓ | ✓ |
| SRO | Fall | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injury | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release