4P9-10174-88721
2 vaccinations
8 coded responses
26 check-ins
8 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 934 / CA
- Registered
- 2021-03-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Registered in v-safe
-
2021-03-03
Dose 1 — Moderna
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2021-03-03
Survey response — day 0, dose 1MedDRA: Mental impairment, Motor dysfunction, Speech disorder — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessFree text: Difficulty forming sentences and thinking clearly, loss of motor control knocking stuff over, closing the car door on my leg somehow, my wife droveMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Survey response — days 1–6 daily, dose 1MedDRA: Cognitive disorder — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesFree text: Still making mistakes, cognitive issuesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-06
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2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Feeling hot — Feeling: Good · Fatigue or tirednessFree text: I felt very warm this morning, but no fever. Ambient temp was was 65°F and body temp was 98.6°FMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-17
- 2021-03-24
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2021-03-31
Dose 2 — Moderna
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2021-03-31
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-04-01
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: Brain FogMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Cough — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Yesterday I was coughing and that was weirdMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Chest discomfort, Dyspnoea — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: Chest tightness when breathingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Chills, Fatigue or tirednessAdult check-in
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2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: Chest discomfort — Feeling: Fair · ChillsFree text: Upper lung tightnessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-07
Survey response — day 7, dose 2MedDRA: Respiratory tract irritation — Feeling: Fair · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Upper lung irritation for the past four days, SpO2 was 91 last night, thankfully 97 this morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-06-30
- 2021-09-29
- 2022-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-31 | Moderna |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Difficulty forming sentences and thinking clearly, loss of motor control knocking stuff over, closing the car door on my leg somehow, my wife drove
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Still making mistakes, cognitive issues
Systemic reaction (other): I felt very warm this morning, but no fever. Ambient temp was was 65°F and body temp was 98.6°F
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Brain Fog
Systemic reaction (other): Yesterday I was coughing and that was weird
Systemic reaction (other): Chest tightness when breathing
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Upper lung tightness
Release 7 — day 7, dose 2
Systemic reaction (other): Upper lung irritation for the past four days, SpO2 was 91 last night, thankfully 97 this morning
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 |
|---|---|---|---|---|
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Cognitive disorder | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Mental impairment | ✓ | ✓ | ✓ |
| SRO | Motor dysfunction | ✓ | ✓ | ✓ |
| SRO | Respiratory tract irritation | ✓ | ✓ | ✓ |
| SRO | Speech disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release