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4S5-16860-40974

2 vaccinations 7 coded responses 19 check-ins 7 free-text entries 0 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
342 / FL
Registered
2021-02-19
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-16
    Dose 1 — Moderna
  2. 2021-02-19
    Registered in v-safe
  3. 2021-02-19
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthralgia, Injected limb mobility decreased, Injection site bruising, Injection site pain — Feeling: Good · Site: Pain · Be unable to work
    Free text: Have 1.5" x 2.5" bruise at shot location.. Shot was very painful, and shoulder was painful and disabled for lifting or reaching out or up, for 48 hours after the shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-20
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site bruising, Injection site joint pain — Feeling: Good · Site: Pain
    Free text: Shoulder joint still painful at injection site, and large bruise remains.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-21
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site bruising, Injection site discolouration, Joint range of motion decreased, Pain — Feeling: Good
    Free text: Bruise at injection site still 1.5"×2.5", now green and purple, still some painful limitation of shoulder joint movement.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-22
    Survey response — days 1–6 daily, dose 1
    MedDRA: Contusion, Injection site joint discomfort — Feeling: Good · Joint pains
    Free text: Still have large bruise and some shoulder-joint pain at injection site.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-23
    Survey response — day 7, dose 1
    MedDRA: Injection site bruising — Feeling: Good
    Free text: Still have big bruise at injection site, now black on yellow-green.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-02
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-03-09
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-03-16
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-18
    Dose 2 — Moderna
  12. 2021-03-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chills — Feeling: Poor · Fever · Chills, Diarrhea · Be unable to work, Be unable to do your normal daily activities
    Free text: Chills, shivering
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Decreased appetite, Hyperhidrosis, Hypersomnia, Pain, Sensitive skin — Feeling: Fair · Fatigue or tiredness · Be unable to work
    Free text: Profuse night-time sweating. No appetite. Sensitive skin (shirt causes pain when moving). Excessive need for sleep.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-25
    Health check-in — day 7, dose 2
    Feeling: Fair · Fatigue or tiredness, Diarrhea · Be unable to work
    Adult check-in
  15. 2021-04-01
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  16. 2021-04-08
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-04-15
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-04-22
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-04-29
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-06-17
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-09-18
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2022-03-20
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-16Moderna
22021-03-18Moderna

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-19

Systemic reaction (other): Have 1.5" x 2.5" bruise at shot location.. Shot was very painful, and shoulder was painful and disabled for lifting or reaching out or up, for 48 hours after the shot.

2021-02-20

Systemic reaction (other): Shoulder joint still painful at injection site, and large bruise remains.

2021-02-21

Systemic reaction (other): Bruise at injection site still 1.5"×2.5", now green and purple, still some painful limitation of shoulder joint movement.

2021-02-22

Systemic reaction (other): Still have large bruise and some shoulder-joint pain at injection site.

Release 4 — day 7, dose 1

2021-02-23

Systemic reaction (other): Still have big bruise at injection site, now black on yellow-green.

Release 6 — days 1–6 daily, dose 2

2021-03-23

Systemic reaction (other): Chills, shivering

2021-03-24

Systemic reaction (other): Profuse night-time sweating. No appetite. Sensitive skin (shirt causes pain when moving). Excessive need for sleep.

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
SROArthralgia ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROContusion ✓ ✓ ✓
SRODecreased appetite ✓ ✓ ✓
SROHyperhidrosis ✓ ✓ ✓
SROHypersomnia ✓ ✓ ✓
SROInjected limb mobility decreased ✓ ✓ ✓
SROInjection site bruising ✓ ✓ ✓
SROInjection site discolouration ✓ ✓ ✓
SROInjection site joint discomfort ✓ ✓ ✓
SROInjection site joint pain ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROJoint range of motion decreased ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROSensitive skin ✓ ✓ ✓

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

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