4RW-18759-21110
2 vaccinations
7 coded responses
15 check-ins
7 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 234 / VA
- Registered
- 2021-01-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
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2021-01-07
Dose 1 — Moderna
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2021-01-08
Registered in v-safe
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2021-01-08
Survey response — days 1–6 daily, dose 1MedDRA: Sensitive skin — Feeling: Fair · Site: Pain · Muscle or body achesFree text: Sensitivity on the area two thirds down towards the tip of my sternum, towards the right of it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-10
- 2021-01-12
- 2021-01-13
- 2021-01-17
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2021-01-23
Survey response — day 14, dose 1MedDRA: Injection site discolouration — Feeling: FairFree text: I have a dark 8 mm diameter spot on the left arm near where the shot was done. I also have a headache but it could be unrelated.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
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2021-02-04
Dose 2 — Moderna
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2021-02-11
Health check-in — day 7, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-18
Survey response — day 14, dose 2MedDRA: Chest discomfort, Sensitisation — Feeling: FairFree text: The right side of my chest feels sensitive. No pain but sensitive.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-25
Survey response — day 21, dose 2MedDRA: Chest discomfort — Feeling: GoodFree text: I feel a bit of pressure in my chest.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Survey response — day 28, dose 2MedDRA: Blepharospasm, Chest discomfort — Feeling: GoodFree text: I have a pressure in my chest and a left eyelid twitch.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Survey response — day 35, dose 2MedDRA: Blepharospasm — Feeling: FairFree text: I have a left eye twitch that started around the time I had the first moderna vaccine. It comes and goes but its very annoying.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
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2021-05-06
Survey response — 3 months, dose 2MedDRA: Myokymia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I have been dealing with myokymia in both eyes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Sensitivity on the area two thirds down towards the tip of my sternum, towards the right of it.
Release 2 — day 14, dose 1
Symptoms: I have a dark 8 mm diameter spot on the left arm near where the shot was done. I also have a headache but it could be unrelated.
Release 4 — day 14, dose 2
Symptoms: The right side of my chest feels sensitive. No pain but sensitive.
Release 4 — day 21, dose 2
Symptoms: I feel a bit of pressure in my chest.
Release 5 — day 28, dose 2
Symptoms: I have a pressure in my chest and a left eyelid twitch.
Release 5 — day 35, dose 2
Symptoms: I have a left eye twitch that started around the time I had the first moderna vaccine. It comes and goes but its very annoying.
Release 8 — 3 months, dose 2
Symptoms: I have been dealing with myokymia in both eyes.
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 | Blepharospasm | ✓ | ✓ | ✓ |
| SD | Chest discomfort | ✓ | ✓ | ✓ |
| SD | Injection site discolouration | ✓ | ✓ | ✓ |
| SD | Myokymia | ✓ | ✓ | ✓ |
| SD | Sensitisation | ✓ | · | ✓ |
| SRO | Sensitive skin | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release