4X8-10715-84949
2 vaccinations
3 coded responses
23 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 958 / CA
- Registered
- 2021-02-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-26
Registered in v-safe
-
2021-02-26
Dose 1 — Moderna
- 2021-02-26
-
2021-02-27
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Fever · Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-03-01
- 2021-03-02
-
2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Cough, Wheezing — Feeling: GoodFree text: Dry cough/wheezy cough infrequentlyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-06
- 2021-03-16
- 2021-03-20
-
2021-03-26
Dose 2 — Moderna
-
2021-03-26
Health check-in — day 0, dose 2Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-09
-
2021-04-16
Survey response — day 21, dose 2MedDRA: Injection site pain, Pain — Feeling: GoodFree text: Sharp pain at the injection site. Like someone gave me a bad Charlie horse in the arm. It is worse when I lift my arm fir any extended period of time.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-06-25
-
2021-09-26
Survey response — 6 months, dose 2MedDRA: Arrhythmia, Pre-existing disease — Feeling: GoodFree text: I had Covid in December 2020. I got vaccinated i. Feb/March 2021 since then I have experienced Heart arrhythmia on occasion. I will need to go to (b)(6) for an EKG to compare to one I had in the late 90s. This sucks!MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-26 | Moderna | |
| 2 | 2021-03-26 | Moderna |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Dry cough/wheezy cough infrequently
Release 7 — day 21, dose 2
Symptoms: Sharp pain at the injection site. Like someone gave me a bad Charlie horse in the arm. It is worse when I lift my arm fir any extended period of time.
Release 9 — 6 months, dose 2
Symptoms: I had Covid in December 2020. I got vaccinated i. Feb/March 2021 since then I have experienced Heart arrhythmia on occasion. I will need to go to (b)(6) for an EKG to compare to one I had in the late 90s. This sucks!
redacted (b)(6)
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 | Arrhythmia | · | · | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Wheezing | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release