4JG-53334-31435
4 vaccinations
5 coded responses
51 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 236 / VA
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Moderna
- 2021-02-03
-
2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Myalgia — Feeling: Good · Site: PainFree text: Muscle ache on injection shoulderMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
-
2021-03-05
Dose 2 — Moderna
-
2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-03-08
-
2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
-
2021-04-09
Survey response — day 35, dose 2MedDRA: Exposure to toxic agent, Rash — Feeling: GoodFree text: Exposure to poison ivy. After 3 weeks body still showing skin rashes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
-
2021-04-21
Call successfulDoes not wish to fill out VAERS report
-
2021-06-04
Survey response — 3 months, dose 2MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Unrelated to COVID or vaccine had problem shaking episode with poison ivy, took 40 days to clear. Included Doc visit and prescription cream to clear it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-04
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-03
-
2021-12-10
Dose 3 — Moderna
-
2021-12-11
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-15
- 2021-12-16
- 2021-12-17
- 2021-12-24
- 2021-12-31
-
2022-01-07
Survey response — day 28, dose 3MedDRA: Exposure to SARS-CoV-2, Pain, Rhinorrhoea, Throat irritation — Feeling: FairFree text: I have Runny nose, scratchy throat, Some aches. I have not been tested. My son has positive COVID test result on Tuesday. In person school & works. Wife is sick but had negative test same day. Both were vaccinated but no booster.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-14
- 2022-01-21
- 2022-03-11
- 2022-04-18
- 2022-06-10
-
2022-10-26
Dose 4 — Moderna
- 2022-10-27
-
2022-10-28
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-10-30
- 2022-10-31
- 2022-11-01
- 2022-11-02
- 2022-11-09
-
2022-11-16
Survey response — day 21, dose 4MedDRA: Nasopharyngitis — Feeling: Poor · Be unable to do your normal daily activitiesFree text: I've had flu vaccine, and Covid booster but caught a bad cold.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-23
- 2022-11-30
- 2022-12-07
- 2023-01-25
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-05 | Moderna | |
| 3 | 2021-12-10 | Moderna | No |
| 4 | 2022-10-26 | Moderna | No |
Call center
1 call center case
1 successful
1 wait over 3 months for a first call
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Muscle ache on injection shoulder
Release 7 — day 35, dose 2
Symptoms: Exposure to poison ivy. After 3 weeks body still showing skin rashes.
Release 8 — 3 months, dose 2
Symptoms: Unrelated to COVID or vaccine had problem shaking episode with poison ivy, took 40 days to clear. Included Doc visit and prescription cream to clear it.
Release 10 — day 28, dose 3
Symptoms: I have Runny nose, scratchy throat, Some aches. I have not been tested. My son has positive COVID test result on Tuesday. In person school & works. Wife is sick but had negative test same day. Both were vaccinated but no booster.
Release 12 — day 21, dose 4
Symptoms: I've had flu vaccine, and Covid booster but caught a bad cold.
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 | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Exposure to toxic agent | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release