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4KH-21115-68079

3 vaccinations 8 coded responses 16 check-ins 8 free-text entries 0 call cases
Sex
Male
Age at first dose
61-65
ZIP prefix
921 / CA
Registered
2021-02-08
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-08
    Registered in v-safe
  2. 2021-02-08
    Dose 1 — Moderna
  3. 2021-02-08
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-02-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Joint pains, Muscle or body aches
    Adult check-in
  5. 2021-02-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Muscular weakness — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Weakness in injection arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-17
    Survey response — day 7, dose 1
    MedDRA: Muscle spasms — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Severe hand cramping
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-01
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  8. 2021-03-08
    Survey response — day 28, dose 1
    MedDRA: Back pain, Irregular breathing, Musculoskeletal stiffness — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Extremely stiff muscles,Stabbing pain through right back area. Pain when breathing in.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-13
    Dose 2 — Moderna
  10. 2021-03-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Arthralgia, Pain, Painful respiration — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Stabbing pain in back right side. Hurts to take deep breath.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-18
    Survey response — days 1–6 daily, dose 2
    MedDRA: Back pain, Painful respiration — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Stabbing pain through right back when taking deep breaths. Gets worse every day.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-20
    Survey response — day 7, dose 2
    MedDRA: Flank pain, Painful respiration — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Severe stabbing pain through back right side when taking breaths. Getting worse daily.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-04-04
    Survey response — day 21, dose 2
    MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Fatigué. Tired all of the time.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-12
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-06-14
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-11-27
    Dose 3 — Moderna
  18. 2022-03-13
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  19. 2022-05-29
    Survey response — 6 months, dose 3
    MedDRA: Cough, Decreased appetite, Fatigue, Headache, Pain, Pyrexia, Respiratory tract congestion — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Congestion, coughing, headache, body aches, fatigue, loss of appetite, feverish
    MedDRA releases: 2024-11 · check-in free text available
  20. 2022-12-03
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-08Moderna
22021-03-13Moderna
32021-11-27Moderna No

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-12

Systemic reaction (other): Weakness in injection arm

Release 4 — day 7, dose 1

2021-02-17

Systemic reaction (other): Severe hand cramping

Release 5 — day 28, dose 1

2021-03-08

Symptoms: Extremely stiff muscles,Stabbing pain through right back area. Pain when breathing in.

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): Stabbing pain in back right side. Hurts to take deep breath.

2021-03-18

Systemic reaction (other): Stabbing pain through right back when taking deep breaths. Gets worse every day.

Release 6 — day 7, dose 2

2021-03-20

Systemic reaction (other): Severe stabbing pain through back right side when taking breaths. Getting worse daily.

Release 6 — day 21, dose 2

2021-04-04

Symptoms: Fatigué. Tired all of the time.

Release 11 — 6 months, dose 3

2022-05-29

Symptoms: Congestion, coughing, headache, body aches, fatigue, loss of appetite, feverish

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
SDBack pain ✓ ✓ ✓
SDCough · · ✓
SDDecreased appetite · · ✓
SDFatigue ✓ ✓ ✓
SDHeadache · · ✓
SDIrregular breathing ✓ ✓ ✓
SDMusculoskeletal stiffness ✓ ✓ ✓
SDPain · · ✓
SDPyrexia · · ✓
SDRespiratory tract congestion · · ✓
SROArthralgia ✓ ✓ ✓
SROBack pain ✓ ✓ ✓
SROFlank pain ✓ ✓ ✓
SROMuscle spasms ✓ ✓ ✓
SROMuscular weakness ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPainful respiration ✓ ✓ ✓

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