4WZ-31655-77076
3 vaccinations
2 coded responses
32 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 598 / MT
- Registered
- 2021-01-08
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- N/A
Timeline
-
2021-01-08
Registered in v-safe
-
2021-01-08
Dose 1 — Moderna
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-13
- 2021-01-15
- 2021-01-22
- 2021-01-29
-
2021-02-05
Dose 2 — Moderna
- 2021-02-05
- 2021-02-06
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Eye pain, Feeling abnormal, Headache, Lacrimation increased — Feeling: Good · HeadacheFree text: I forgot to mention a symptom I noticed yesterday. Yesterday, during the day, I had this unusual feeling in my head. It wasnt pressure or a headache. It was painful or uncomfortable. Then about 8:30 pm it hurt to move my eyes in certain directions. Finally about 10 pm, my eyes watered for a minute or so. Then the rest of the evening, the inside of my head felt sore. When I woke up this morning, I didnt feel that sensation in my head. Even though it felt that odd feeling in my head yesterday, I felt good during the day and was able to go for a walk and do all the usual things I would do in the normal way.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-05-07
- 2021-08-06
- 2022-02-05
-
2022-04-09
Dose 3 — Moderna
- 2022-04-24
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-07-10
-
2022-10-08
Survey response — 6 months, dose 3MedDRA: COVID-19 — Feeling: GoodFree text: I contracted COVID.MedDRA releases: 2024-11 · check-in free text available
- 2023-04-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-05 | Moderna | |
| 3 | 2022-04-09 | Moderna | No |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): I forgot to mention a symptom I noticed yesterday. Yesterday, during the day, I had this unusual feeling in my head. It wasnt pressure or a headache. It was painful or uncomfortable. Then about 8:30 pm it hurt to move my eyes in certain directions. Finally about 10 pm, my eyes watered for a minute or so. Then the rest of the evening, the inside of my head felt sore. When I woke up this morning, I didnt feel that sensation in my head. Even though it felt that odd feeling in my head yesterday, I felt good during the day and was able to go for a walk and do all the usual things I would do in the normal way.
Release 12 — 6 months, dose 3
Symptoms: I contracted COVID.
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 | COVID-19 | · | · | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Lacrimation increased | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release