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4TP-81804-68545

2 vaccinations 9 coded responses 22 check-ins 9 free-text entries 0 call cases
Sex
Male
Age at first dose
56-60
ZIP prefix
606 / IL
Registered
2021-03-02
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-02
    Registered in v-safe
  2. 2021-03-02
    Dose 1 — Moderna
  3. 2021-03-02
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-03-03
    Survey response — days 1–6 daily, dose 1
    MedDRA: Headache — Feeling: Fair · Site: Pain · Fever · Chills
    Free text: Nothing special except a little headache this evening on the left side of my head, but bearable.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: No adverse event — Feeling: Fair · Fatigue or tiredness
    Free text: Non
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-06
    Survey response — days 1–6 daily, dose 1
    MedDRA: No adverse event — Feeling: Good
    Free text: None
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: No adverse event — Feeling: Good
    Free text: None
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-08
    Survey response — days 1–6 daily, dose 1
    MedDRA: No adverse event — Feeling: Good
    Free text: None
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-09
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-16
    Survey response — day 14, dose 1
    MedDRA: Dizziness, Dizziness postural, Fatigue — Feeling: Fair
    Free text: I feel a little tired and dizzy when I stand up.My blood pressure is good at 103/65/90 around 14:40pm.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-23
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  12. 2021-03-30
    Dose 2 — Moderna
  13. 2021-03-30
    Survey response — day 0, dose 2
    MedDRA: Dizziness postural — Feeling: Fair
    Free text: I get dizzy when I stand up and its been happening for around 10 days now.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-31
    Survey response — days 1–6 daily, dose 2
    MedDRA: Asthenia, Dizziness, Malaise — Feeling: Poor · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: The dizziness is gone today but I feel very wick and sick without being able to point exactly what is the pain.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · None
    Adult check-in
  16. 2021-04-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  17. 2021-04-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-04-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-04-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-04-06
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-04-13
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-04-20
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-27
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-04
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-11
    Survey response — day 42, dose 2
    MedDRA: Dizziness — Feeling: Fair
    Free text: I feel a little dizzy or light headed. I am little unbalanced. When I stand up straight from a sitting position or bed I feel dizzy the most.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-03-02Moderna
22021-03-30Moderna

Free text

Release 4 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Nothing special except a little headache this evening on the left side of my head, but bearable.

Release 5 — days 1–6 daily, dose 1

2021-03-05

Systemic reaction (other): Non

2021-03-06

Systemic reaction (other): None

2021-03-07

Systemic reaction (other): None

2021-03-08

Systemic reaction (other): None

Release 5 — day 14, dose 1

2021-03-16

Symptoms: I feel a little tired and dizzy when I stand up.My blood pressure is good at 103/65/90 around 14:40pm.

Release 6 — day 0, dose 2

2021-03-30

Systemic reaction (other): I get dizzy when I stand up and its been happening for around 10 days now.

Release 6 — days 1–6 daily, dose 2

2021-03-31

Systemic reaction (other): The dizziness is gone today but I feel very wick and sick without being able to point exactly what is the pain.

Release 8 — day 42, dose 2

2021-05-11

Symptoms: I feel a little dizzy or light headed. I am little unbalanced. When I stand up straight from a sitting position or bed I feel dizzy the most.

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
SDDizziness ✓ ✓ ✓
SDDizziness postural ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SROAsthenia ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SRODizziness postural ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROMalaise ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓

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

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