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4P5-16441-87460

2 vaccinations 15 coded responses 23 check-ins 15 free-text entries 0 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
735 / OK
Registered
2021-03-25
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-25
    Registered in v-safe
  2. 2021-03-25
    Dose 1 — Moderna
  3. 2021-03-25
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain · Fever · Fatigue or tiredness, Abdominal pain
    Adult check-in
  4. 2021-03-27
    Survey response — days 1–6 daily, dose 1
    MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness
    Free text: No
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-29
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-30
    Survey response — days 1–6 daily, dose 1
    MedDRA: No adverse event — Feeling: Good
    Free text: No
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-31
    Survey response — days 1–6 daily, dose 1
    MedDRA: No adverse event — Feeling: Fair · Fatigue or tiredness
    Free text: No
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-01
    Health check-in — day 7, dose 1
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  10. 2021-04-08
    Survey response — day 14, dose 1
    MedDRA: Eye pain, Rhinorrhoea, Sneezing — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Runny nose and sneezing eyes hurting
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-15
    Survey response — day 21, dose 1
    MedDRA: Epistaxis — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Woke up 3 am Wednesday nose full of blood general feeling bad nose quit bleeding short time
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-22
    Dose 2 — Moderna
  13. 2021-04-22
    Survey response — day 0, dose 2
    MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness
    Free text: No
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Fatigue or tiredness
    Free text: Somewhat short of breath
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dyspnoea, Feeling hot — Feeling: Fair · Fatigue or tiredness
    Free text: Felt hot not fever difficulty breathing then fell asleep slept good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Sore throat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Asthenia, Chest discomfort, Chest pain — Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Chest pain and tightness, weakness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-27
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chest discomfort — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Titeness in chest
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-04-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: Asthenia — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Very week
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-04-29
    Survey response — day 7, dose 2
    MedDRA: Asthenia, Decreased appetite, Pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: WWeakness lack appetite general soreness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-05-08
    Survey response — day 14, dose 2
    MedDRA: Blood glucose increased, Hospitalisation — Feeling: Poor · Be unable to do your normal daily activities
    Free text: 685 blood sugar week in hospital now on insulin
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-05-13
    Survey response — day 21, dose 2
    MedDRA: Hospitalisation, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Diabetes week in hospital
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-05-20
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  24. 2021-05-27
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  25. 2021-06-03
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  26. 2021-07-23
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-25Moderna
22021-04-22Moderna

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-27

Systemic reaction (other): No

2021-03-30

Systemic reaction (other): No

2021-03-31

Systemic reaction (other): No

Release 7 — day 14, dose 1

2021-04-08

Symptoms: Runny nose and sneezing eyes hurting

Release 7 — day 21, dose 1

2021-04-15

Symptoms: Woke up 3 am Wednesday nose full of blood general feeling bad nose quit bleeding short time

Release 7 — day 0, dose 2

2021-04-22

Systemic reaction (other): No

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): Somewhat short of breath

2021-04-24

Systemic reaction (other): Felt hot not fever difficulty breathing then fell asleep slept good

2021-04-25

Systemic reaction (other): Sore throat

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Chest pain and tightness, weakness

2021-04-27

Systemic reaction (other): Titeness in chest

2021-04-28

Systemic reaction (other): Very week

Release 8 — day 7, dose 2

2021-04-29

Systemic reaction (other): WWeakness lack appetite general soreness

Release 8 — day 14, dose 2

2021-05-08

Symptoms: 685 blood sugar week in hospital now on insulin

Release 8 — day 21, dose 2

2021-05-13

Symptoms: Diabetes week in hospital

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
SDBlood glucose increased ✓ ✓ ✓
SDEpistaxis ✓ ✓ ✓
SDEye pain ✓ ✓ ✓
SDHospitalisation ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓
SDSneezing ✓ ✓ ✓
SROAsthenia ✓ ✓ ✓
SROChest discomfort ✓ ✓ ✓
SROChest pain ✓ ✓ ✓
SRODecreased appetite ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROFeeling hot ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROPain ✓ ✓ ✓

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

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