4U3-27305-63944
5 vaccinations
8 coded responses
33 check-ins
8 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 006 / PR
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-16
Registered in v-safe
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2021-03-18
Dose 1 — Moderna
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2021-03-18
Survey response — day 0, dose 1MedDRA: Asthenia — Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: WeakMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-03-20
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: PainFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-04-01
- 2021-04-08
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2021-04-13
Dose 2 — Moderna
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2021-04-14
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: The area around my waistline and legs hurt very muchMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-16
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2021-04-18
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Site: ItchingFree text: Got a rash on my head , on the back part.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteFree text: Yeah I still have that Rash on the back part of my head.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-22
- 2021-04-27
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2021-05-04
Survey response — day 21, dose 2MedDRA: Inflammation — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Nerver had this happen to me but around my hip area it has become inflamed and I have no idea whats going on there. Just dont know if its related to the vaccine but not feeling to good in that area.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-07-13
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2021-10-12
Survey response — 6 months, dose 2MedDRA: Blood glucose increased — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: May sugar level's have been going up,MedDRA releases: 2024-11 · check-in free text available
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2021-10-12
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
- 2021-10-18
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2021-10-24
Dose 3 — Moderna
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2022-04-13
Survey response — 12 months, dose 2MedDRA: Hypoacusis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I have noticed that I am having a bit of trouble hearing thingsMedDRA releases: 2024-11 · check-in free text available
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2022-05-11
Dose 4 — Moderna
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2022-09-08
Dose 5 — ModernaCo-administered: Flu
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2022-09-10
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
- 2022-09-11
- 2022-09-12
- 2022-09-22
- 2022-09-30
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-12-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-13 | Moderna | |
| 3 | 2021-10-24 | Moderna | No |
| 4 | 2022-05-11 | Moderna | No |
| 5 | 2022-09-08 | Moderna | Flu |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Weak
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): None
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): The area around my waistline and legs hurt very much
Systemic reaction (other): Got a rash on my head , on the back part.
Systemic reaction (other): Yeah I still have that Rash on the back part of my head.
Release 8 — day 21, dose 2
Symptoms: Nerver had this happen to me but around my hip area it has become inflamed and I have no idea whats going on there. Just dont know if its related to the vaccine but not feeling to good in that area.
Release 10 — 6 months, dose 2
Symptoms: May sugar level's have been going up,
Release 11 — 12 months, dose 2
Symptoms: I have noticed that I am having a bit of trouble hearing things
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 | Blood glucose increased | · | · | ✓ |
| SD | Hypoacusis | · | · | ✓ |
| SD | Inflammation | ✓ | ✓ | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release