4WA-19923-56606
5 vaccinations
1 coded response
4 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 917 / CA
- Registered
- 2022-11-25
- Relationship
- Adult relative or friend
- Guardian
- 5A4-22252-05894
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-02-02
Dose 1 — Moderna
-
2021-03-02
Dose 2 — Moderna
-
2021-09-13
Dose 3 — ModernaCo-administered: Tetanus
-
2022-04-15
Dose 4 — Moderna
-
2022-10-21
Dose 5 — Moderna
-
2022-11-25
Registered in v-safe
- 2022-11-25
-
2022-12-02
Survey response — day 42, dose 5, dependentMedDRA: Bone pain, Myalgia — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Bones hurt and MusclesMedDRA releases: 2024-11 · check-in free text available
- 2023-01-21
- 2023-04-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-02 | Moderna | No |
| 2 | 2021-03-02 | Moderna | No |
| 3 | 2021-09-13 | Moderna | Tetanus |
| 4 | 2022-04-15 | Moderna | No |
| 5 | 2022-10-21 | Moderna | No |
Free text
Release 12 — day 42, dose 5, dependent
Symptoms: Bones hurt and Muscles
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 | Bone pain | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release