4WM-27129-71787
2 vaccinations
4 coded responses
14 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 775 / TX
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-07
Dose 1 — Moderna
-
2021-02-04
Registered in v-safe
-
2021-02-04
Dose 2 — Moderna
- 2021-02-04
-
2021-02-05
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaFree text: No appetite. I ate but mainly low carb breadMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Injection site hypersensitivity, Injection site warmth, Self-medication — Feeling: Fair · Site: Swelling · Fever · Fatigue or tirednessFree text: I took 30mg of Tylenol last night. I felt much better mostvif the day. Temp was 98.1 this morning. The warm feeling started around 5 pm. Injection site is a little sensitive and geels warmer than the opposite arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
-
2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Mild soreness/sensitive at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-20
- 2021-02-27
- 2021-03-04
- 2021-03-13
- 2021-03-18
- 2021-05-06
- 2021-08-05
-
2022-02-04
Survey response — 12 months, dose 2MedDRA: Myocardial infarction, Vascular graft — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I had a heart attack and bypass surgery 4 months ago, not related to COVID. I since had the FULL Moderna third booster. I am doing great.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): No appetite. I ate but mainly low carb bread
Systemic reaction (other): I took 30mg of Tylenol last night. I felt much better mostvif the day. Temp was 98.1 this morning. The warm feeling started around 5 pm. Injection site is a little sensitive and geels warmer than the opposite arm.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Mild soreness/sensitive at injection site.
Release 11 — 12 months, dose 2
Symptoms: I had a heart attack and bypass surgery 4 months ago, not related to COVID. I since had the FULL Moderna third booster. I am doing great.
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 | Myocardial infarction | · | · | ✓ |
| SD | Vascular graft | · | · | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Injection site hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release