4LB-13862-33533
2 vaccinations
4 coded responses
12 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 307 / GA
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Dose 1 — Moderna
-
2021-01-29
Registered in v-safe
-
2021-01-29
Survey response — days 1–6 daily, dose 1MedDRA: Cough, Mobility decreased, Pain in extremity, Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Excruciating pain in arm. Difficult to even .move arm.Corona cough came back.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Survey response — day 7, dose 1MedDRA: Cough, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: Runny nose and congestion, and coughingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Survey response — day 14, dose 1MedDRA: Analgesic drug level, Chills, Cough, Dizziness, Fatigue, Feeling abnormal — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Daily, mild, changing symptoms. Monday mild cough and chills. Tuesday, was fatigue, Wednesday was brain fog and fatigue, Thursday was dizziness, Today is headache. Acetaminophen works wonders. 1 pill is good for 3 to 6 hours. Usually, one is enough.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
- 2021-02-25
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2021-02-28
Dose 2 — Moderna
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2021-03-08
Survey response — day 7, dose 2MedDRA: Feeling abnormal, Memory impairment — Feeling: Good · Chills, Fatigue or tirednessFree text: Some brain fog. Couldn't remember my niece's name. After much concentration it cane back.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-14
- 2021-03-21
- 2021-03-30
- 2021-04-06
- 2021-05-31
- 2022-02-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-28 | Moderna |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Excruciating pain in arm. Difficult to even .move arm.Corona cough came back.
Release 3 — day 7, dose 1
Systemic reaction (other): Runny nose and congestion, and coughing
Release 4 — day 14, dose 1
Symptoms: Daily, mild, changing symptoms. Monday mild cough and chills. Tuesday, was fatigue, Wednesday was brain fog and fatigue, Thursday was dizziness, Today is headache. Acetaminophen works wonders. 1 pill is good for 3 to 6 hours. Usually, one is enough. cut off by CDC
Release 5 — day 7, dose 2
Systemic reaction (other): Some brain fog. Couldn't remember my niece's name. After much concentration it cane back.
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 | Analgesic drug level | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Memory impairment | ✓ | ✓ | ✓ |
| SRO | Mobility decreased | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release