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4VB-21079-24634

2 vaccinations 8 coded responses 14 check-ins 8 free-text entries 0 call cases
Sex
Male
Age at first dose
51-55
ZIP prefix
379 / TN
Registered
2021-07-04
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-06-04
    Dose 1 — Moderna
  2. 2021-07-02
    Dose 2 — Moderna
  3. 2021-07-04
    Registered in v-safe
  4. 2021-07-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blood glucose increased, Diabetes mellitus, Pre-existing disease — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Blood sugar is higher than normal (Type 2)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-07-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blood glucose increased — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Blood sugar higher than normal
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-07-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blood glucose increased, Diabetes mellitus, Pre-existing disease — Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tiredness, Diarrhea
    Free text: Blood sugar still higher than normal (type 2)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-07-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Diarrhea
    Adult check-in
  8. 2021-07-08
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blood glucose increased — Feeling: Good · Site: Redness, Itching · Headache
    Free text: My fasting Blood Sugar was over 300+ this morning at 10am no food in 12 hours prior. Never has that happened in my life. Feel sure that bloos sugars have been much higher post second shot
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-07-09
    Survey response — day 7, dose 2
    MedDRA: Blood glucose increased — Feeling: Good · Site: Itching · Headache
    Free text: Higher blood sugar than normal
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-07-16
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-07-23
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-07-30
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-08-07
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-08-13
    Survey response — day 42, dose 2
    MedDRA: Fluid retention, Joint swelling, Pain in extremity, Tendon pain — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Ankles swelling and extreme pain in my achilles and heal areas. Looks like fluid is gathering
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  15. 2021-10-01
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-12-31
    Survey response — 6 months, dose 2
    MedDRA: Arthralgia, Tendon pain — Feeling: Good · Be unable to do your normal daily activities
    Free text: I continue to have joint and tendon pain. More recently my shoulder pain at times is very difficult to deal with.
    MedDRA releases: 2024-11 · check-in free text available
  17. 2022-07-02
    Survey response — 12 months, dose 2
    MedDRA: Blood glucose increased — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Since I was vaxed my blood sugars continue to rise abnormally. I had to start insulin and Ozempic
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-06-04Moderna No
22021-07-02Moderna No

Free text

Release 9 — days 1–6 daily, dose 2

2021-07-04

Systemic reaction (other): Blood sugar is higher than normal (Type 2)

2021-07-05

Systemic reaction (other): Blood sugar higher than normal

2021-07-06

Systemic reaction (other): Blood sugar still higher than normal (type 2)

2021-07-08

Systemic reaction (other): My fasting Blood Sugar was over 300+ this morning at 10am no food in 12 hours prior. Never has that happened in my life. Feel sure that bloos sugars have been much higher post second shot

Release 9 — day 7, dose 2

2021-07-09

Systemic reaction (other): Higher blood sugar than normal

Release 9 — day 42, dose 2

2021-08-13

Symptoms: Ankles swelling and extreme pain in my achilles and heal areas. Looks like fluid is gathering

Release 10 — 6 months, dose 2

2021-12-31

Symptoms: I continue to have joint and tendon pain. More recently my shoulder pain at times is very difficult to deal with.

Release 12 — 12 months, dose 2

2022-07-02

Symptoms: Since I was vaxed my blood sugars continue to rise abnormally. I had to start insulin and Ozempic

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
SDArthralgia · · ✓
SDBlood glucose increased · · ✓
SDFluid retention ✓ · ✓
SDJoint swelling ✓ · ✓
SDPain in extremity ✓ · ✓
SDTendon pain ✓ · ✓
SROBlood glucose increased ✓ ✓ ✓
SRODiabetes mellitus ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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