4S4-17433-88308
3 vaccinations
2 coded responses
41 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 31-35
- ZIP prefix
- 928 / CA
- Registered
- 2021-04-12
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-12
Registered in v-safe
-
2021-04-12
Dose 1 — Moderna
- 2021-04-12
- 2021-04-13
- 2021-04-14
-
2021-04-15
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
-
2021-04-26
Survey response — day 14, dose 1MedDRA: Rash, Rash pruritic — Feeling: GoodFree text: Developed a splotchy oval shaped rash on my vaccine arm on the 8th day. 9th day - the whole oval was red (not splotchy), minor itchiness and a bit of soreness. 10th day to today, the oval became less and less noticeable, no pain nor itchiness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-05
Survey response — day 21, dose 1MedDRA: Dizziness, Headache, Syncope — Feeling: GoodFree text: A couple of headaches that are most likely unrelated to the vaccine. Fainted/lightheadedness on Monday, but also pretty sure it was unrelated to the vaccine. Currently in good health.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-12
Dose 2 — Moderna
- 2021-05-12
-
2021-05-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-05-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness · Muscle or body achesAdult check-in
- 2021-05-15
- 2021-05-16
- 2021-05-17
- 2021-05-18
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
- 2021-06-16
- 2021-06-23
- 2021-08-11
- 2021-11-10
-
2021-12-14
Dose 3 — Moderna
- 2021-12-14
- 2021-12-15
- 2021-12-16
-
2021-12-17
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Itching · Headache, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-12-18
- 2021-12-19
- 2021-12-20
- 2021-12-21
- 2021-12-28
- 2022-01-04
- 2022-01-11
- 2022-01-18
- 2022-01-25
- 2022-03-15
- 2022-06-14
- 2022-12-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-12 | Moderna | |
| 2 | 2021-05-12 | Moderna | |
| 3 | 2021-12-14 | Moderna | No |
Free text
Release 8 — day 14, dose 1
Symptoms: Developed a splotchy oval shaped rash on my vaccine arm on the 8th day. 9th day - the whole oval was red (not splotchy), minor itchiness and a bit of soreness. 10th day to today, the oval became less and less noticeable, no pain nor itchiness.
Release 8 — day 21, dose 1
Symptoms: A couple of headaches that are most likely unrelated to the vaccine. Fainted/lightheadedness on Monday, but also pretty sure it was unrelated to the vaccine. Currently in good health.
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 | Dizziness | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release