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4SC-50684-14813

5 vaccinations 9 coded responses 42 check-ins 9 free-text entries 2 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
921 / CA
Registered
2021-02-04
Relationship
Self
Race
Other
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-02-04
    Registered in v-safe
  2. 2021-02-04
    Dose 1 — Moderna
  3. 2021-02-04
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-02-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-02-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea
    Adult check-in
  6. 2021-02-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-11
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-02-18
    Survey response — day 14, dose 1
    MedDRA: Injection site rash, Pruritus, Skin warm — Feeling: Good
    Free text: About 3 or 4 days ago a large red spot appeared at the injection site. It was warm and iched but not sore. Today spot seems lighter and not itching.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-25
    Survey response — day 21, dose 1
    MedDRA: Fatigue, Sinus headache — Feeling: Good · Be unable to do your normal daily activities
    Free text: Sinus headache and tired.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-04
    Dose 2 — Moderna
  14. 2021-03-04
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-03-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Symptoms stated about 2am.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chills, Fatigue, Pyrexia — Feeling: Fair · Site: Redness · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Fatigue may be from last night's fever and chills.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness · None
    Adult check-in
  18. 2021-03-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness · None
    Adult check-in
  19. 2021-03-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · None
    Adult check-in
  20. 2021-03-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-03-11
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-03-18
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-25
    Survey response — day 21, dose 2
    MedDRA: Fatigue — Feeling: Good
    Free text: Extremely tired for a couple of days.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-04-01
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-08
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-04-15
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-06-03
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-09-02
    Survey response — 6 months, dose 2
    MedDRA: Fatigue, Sinus headache — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Sinus headache and feeling tired.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  29. 2021-11-05
    Dose 3 — Moderna
  30. 2022-03-04
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  31. 2022-04-12
    Dose 4 — Moderna
  32. 2022-04-25
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  33. 2022-04-26
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  34. 2022-05-03
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  35. 2022-05-11
    Survey response — day 28, dose 4
    MedDRA: Cough, Fatigue, Pyrexia, Sputum discoloured — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Fever, cough, brown phlegm, super tired.
    MedDRA releases: 2024-11 · check-in free text available
  36. 2022-05-11
    Report sent to call center — day 28, dose 4
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  37. 2022-05-12
  38. 2022-05-17
    Health check-in — day 35, dose 4
    Feeling: Fair
    Adult check-in
  39. 2022-05-24
    Health check-in — day 42, dose 4
    Feeling: Fair
    Adult check-in
  40. 2022-07-12
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  41. 2022-10-05
    Dose 5 — Moderna
    Co-administered: Flu
  42. 2022-10-11
    Survey response — 6 months, dose 4
    MedDRA: Influenza, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Came down with the flu. Tested for covid and it came back negative.
    MedDRA releases: 2024-11 · check-in free text available
  43. 2022-10-11
    Report sent to call center — 6 months, dose 4
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  44. 2022-10-12
    Call successful
    Not applicable - Accidental Reporting
  45. 2022-10-12
    Call successful
    Not applicable - Accidental Reporting
  46. 2022-10-15
    Health check-in — day 7, dose 5
    Feeling: Good · None
    Adult check-in
  47. 2022-10-19
    Health check-in — day 14, dose 5
    Feeling: Good
    Adult check-in
  48. 2022-10-26
    Survey response — day 21, dose 5
    MedDRA: Eye pruritus, Rhinorrhoea, Sinus disorder — Feeling: Fair
    Free text: Sinus issues. Nose draining, eyes itching. Possibly alergies.
    MedDRA releases: 2024-11 · check-in free text available
  49. 2022-11-02
    Health check-in — day 28, dose 5
    Feeling: Good
    Adult check-in
  50. 2022-11-09
    Health check-in — day 35, dose 5
    Feeling: Good
    Adult check-in
  51. 2022-11-16
    Health check-in — day 42, dose 5
    Feeling: Good
    Adult check-in
  52. 2023-01-04
    Health check-in — 3 months, dose 5
    Feeling: Good
    Adult check-in
  53. 2023-04-05
    Health check-in — 6 months, dose 5
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-04Moderna
22021-03-04Moderna
32021-11-05Moderna No
42022-04-12Moderna No
52022-10-05Moderna Flu

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-18

Symptoms: About 3 or 4 days ago a large red spot appeared at the injection site. It was warm and iched but not sore. Today spot seems lighter and not itching.

Release 4 — day 21, dose 1

2021-02-25

Symptoms: Sinus headache and tired.

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Symptoms stated about 2am.

2021-03-06

Systemic reaction (other): Fatigue may be from last night's fever and chills.

Release 6 — day 21, dose 2

2021-03-25

Symptoms: Extremely tired for a couple of days.

Release 9 — 6 months, dose 2

2021-09-02

Symptoms: Sinus headache and feeling tired.

Release 11 — day 28, dose 4

2022-05-11

Symptoms: Fever, cough, brown phlegm, super tired.

Release 12 — 6 months, dose 4

2022-10-11

Symptoms: Came down with the flu. Tested for covid and it came back negative.

Release 12 — day 21, dose 5

2022-10-26

Symptoms: Sinus issues. Nose draining, eyes itching. Possibly alergies.

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
SDCough · · ✓
SDEye pruritus · · ✓
SDFatigue ✓ ✓ ✓
SDInfluenza · · ✓
SDInjection site rash ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDPyrexia · · ✓
SDRhinorrhoea · · ✓
SDSARS-CoV-2 test negative · · ✓
SDSinus disorder · · ✓
SDSinus headache ✓ ✓ ✓
SDSkin warm ✓ ✓ ✓
SDSputum discoloured · · ✓
SROChills ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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

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