4LS-23262-30686
4 vaccinations
9 coded responses
23 check-ins
9 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 300 / GA
- Registered
- 2021-11-05
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Dose 1 — Moderna
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2021-03-31
Dose 2 — Moderna
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2021-11-05
Registered in v-safe
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2021-11-05
Dose 3 — Moderna
-
2021-11-05
Survey response — day 0, dose 3MedDRA: Eczema, Psoriasis — Feeling: GoodFree text: I never had eczema or psoriasis I have noticed that there are Several spots on my body But I don't think this has anything to do with the vaccinations I hadMedDRA releases: 2024-11 · check-in free text available
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2021-11-06
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
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2021-11-08
Survey response — days 1–6 daily, dose 3MedDRA: Rash — Feeling: Fair · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection siteFree text: There are 3 bumps on my lower buttocks areaMedDRA releases: 2024-11 · check-in free text available
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2021-11-09
Survey response — days 1–6 daily, dose 3MedDRA: Rash — Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection siteFree text: The rash has never been On the injection site but it's always been like 2" below the injection sisite now it is moved like toward my bicep left left arm bicepMedDRA releases: 2024-11 · check-in free text available
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2021-11-11
Survey response — days 1–6 daily, dose 3MedDRA: Rash — Feeling: Fair · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection siteFree text: There are 2 bumps on the left side of my lower backMedDRA releases: 2024-11 · check-in free text available
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2021-11-19
Survey response — day 14, dose 3MedDRA: Psoriasis — Feeling: GoodFree text: I got these psoriasis type of of mark's on me I don't think it has anything to do withMedDRA releases: 2024-11 · check-in free text available
- 2021-11-26
- 2021-12-06
- 2022-02-04
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2022-04-26
Dose 4 — Moderna
- 2022-04-26
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2022-04-27
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
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2022-04-28
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-01
- 2022-05-02
- 2022-05-05
- 2022-05-10
- 2022-05-17
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2022-05-24
Survey response — day 28, dose 4MedDRA: Cardiac disorder, Office visit, Pre-existing disease — Feeling: GoodFree text: 2 weeks ago the doctors said I have heart disease.... at 56 years old.. I was shocked. I have eaten healthy all my life and worked out. .. the doctor's said it was HereditaryMedDRA releases: 2024-11 · check-in free text available
- 2022-06-02
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2022-06-07
Survey response — day 42, dose 4MedDRA: Myalgia — Feeling: GoodFree text: My muscle aches at night because of the LipitorMedDRA releases: 2024-11 · check-in free text available
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2022-07-26
Survey response — 3 months, dose 4MedDRA: Unevaluable event — Feeling: GoodFree text: I had a stress test at the cardiology departmentMedDRA releases: 2024-11 · check-in free text available
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2022-10-27
Survey response — 6 months, dose 4MedDRA: COVID-19 — Feeling: Poor · Be unable to work or attend schoolFree text: I caught covidMedDRA releases: 2024-11 · check-in free text available
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | No |
| 2 | 2021-03-31 | Moderna | No |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-04-26 | Moderna | No |
Free text
Release 10 — day 0, dose 3
Systemic reaction (other): I never had eczema or psoriasis I have noticed that there are Several spots on my body But I don't think this has anything to do with the vaccinations I had
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): There are 3 bumps on my lower buttocks area
Systemic reaction (other): The rash has never been On the injection site but it's always been like 2" below the injection sisite now it is moved like toward my bicep left left arm bicep
Systemic reaction (other): There are 2 bumps on the left side of my lower back
Release 10 — day 14, dose 3
Symptoms: I got these psoriasis type of of mark's on me I don't think it has anything to do with
Release 11 — day 28, dose 4
Symptoms: 2 weeks ago the doctors said I have heart disease.... at 56 years old.. I was shocked. I have eaten healthy all my life and worked out. .. the doctor's said it was Hereditary
Release 11 — day 42, dose 4
Symptoms: My muscle aches at night because of the Lipitor
Release 12 — 3 months, dose 4
Symptoms: I had a stress test at the cardiology department
Release 12 — 6 months, dose 4
Symptoms: I caught covid
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 | Cardiac disorder | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Psoriasis | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Eczema | · | · | ✓ |
| SRO | Psoriasis | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release