4RV-30432-02748
3 vaccinations
4 coded responses
26 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 857 / AZ
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Registered in v-safe
-
2021-01-20
Dose 1 — Moderna
- 2021-01-20
-
2021-01-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-02-03
- 2021-02-10
- 2021-02-17
-
2021-02-18
Dose 2 — Moderna
- 2021-02-24
-
2021-02-25
Survey response — day 7, dose 2MedDRA: Dizziness, Fatigue, Impaired driving ability, Loss of consciousness, Pain, Pyrexia — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesFree text: I was repeatedly dizzy after my second vaccination. Approximately 1.5 hrs after that vaccination, I passed out and was woken by a woman who found me laying against my car steering wheel with the horn going off. (I had pulled over due to feeling dizzy). Dizziness and lightheadedness passed after about 5 hours. Fever, aches and fatigue followed and lasted about 24 hours. Then I felt fine. I did not receive this survey until several days after my second vaccination, and it only asks about thr previous 24 hour period. So I thought I would report it in this field..MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
-
2021-03-11
Survey response — day 21, dose 2MedDRA: Diarrhoea — Feeling: GoodFree text: DiarrheaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
- 2021-03-27
- 2021-04-03
- 2021-05-20
-
2021-08-19
Survey response — 6 months, dose 2MedDRA: Diarrhoea, Pre-existing disease — Feeling: GoodFree text: Diarrhea lasting about 2 weeks -- believed to be associated with Celiac DiseaseMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-06
Dose 3 — ModernaCo-administered: Flu
- 2021-10-25
- 2021-10-27
- 2021-11-03
- 2021-11-11
- 2022-01-08
-
2022-04-06
Survey response — 6 months, dose 3MedDRA: Nasopharyngitis — Feeling: GoodFree text: Cold like symptoms.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-18 | Moderna | |
| 3 | 2021-10-06 | Moderna | Flu |
Free text
Release 4 — day 7, dose 2
Systemic reaction (other): I was repeatedly dizzy after my second vaccination. Approximately 1.5 hrs after that vaccination, I passed out and was woken by a woman who found me laying against my car steering wheel with the horn going off. (I had pulled over due to feeling dizzy). Dizziness and lightheadedness passed after about 5 hours. Fever, aches and fatigue followed and lasted about 24 hours. Then I felt fine. I did not receive this survey until several days after my second vaccination, and it only asks about thr previous 24 hour period. So I thought I would report it in this field..
Release 5 — day 21, dose 2
Symptoms: Diarrhea
Release 9 — 6 months, dose 2
Symptoms: Diarrhea lasting about 2 weeks -- believed to be associated with Celiac Disease
Release 11 — 6 months, dose 3
Symptoms: Cold like symptoms.
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 | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Impaired driving ability | ✓ | ✓ | ✓ |
| SRO | Loss of consciousness | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release