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4XE-11284-65951

2 vaccinations 16 coded responses 22 check-ins 16 free-text entries 0 call cases
Sex
Male
Age at first dose
61-65
ZIP prefix
980 / WA
Registered
2021-02-02
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-31
    Dose 1 — Moderna
  2. 2021-02-02
    Registered in v-safe
  3. 2021-02-02
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  4. 2021-02-03
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthralgia, Headache — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain
    Free text: I didnt tell on the first day I got headache and sore shoulder where I got the shot. That night very sore shoulder during night that woke me and then sore shoulder but better than during the night.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: Headache — Feeling: Fair · Headache
    Free text: Just have very mild headache. I seldom get headaches so it a little annoying.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-06
    Survey response — days 1–6 daily, dose 1
    MedDRA: Feeling abnormal — Feeling: Fair · Headache, Fatigue or tiredness
    Free text: It has been 6 days and I dont feel normal. Is this anything I should be concerned with?
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-09
    Survey response — day 7, dose 1
    MedDRA: Dyspnoea, Rhinorrhoea — Feeling: Fair · Headache, Joint pains
    Free text: One thing I have had a runny nose for 8 days and some shortness of breath also.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-14
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-02-21
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-27
    Dose 2 — Moderna
  11. 2021-02-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Free text: I never told you after the first shot I had severe brain fog, Im hoping I dont get it again after shot # 2. It lasted about 3 weeks!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain
    Adult check-in
  13. 2021-03-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Joint pains
    Free text: Brain fog
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Fair · Joint pains
    Free text: Brain fog
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Fair · Joint pains
    Free text: Brain fog
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Fair · Joint pains
    Free text: Still have lingering brain fog
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-06
    Survey response — day 7, dose 2
    MedDRA: Feeling abnormal — Feeling: Fair · Fatigue or tiredness
    Free text: Brain fog
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-03-15
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  19. 2021-03-20
    Survey response — day 21, dose 2
    MedDRA: Feeling abnormal, Headache — Feeling: Fair
    Free text: Some brain fog still and some headaches. I never get headaches so thats why Im mentioning it.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-03-28
    Survey response — day 28, dose 2
    MedDRA: Arthralgia, Feeling abnormal — Feeling: Fair
    Free text: Still have brain fog but also my joints seem to hurt more
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-04-04
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  22. 2021-04-10
    Survey response — day 42, dose 2
    MedDRA: Unevaluable event — Feeling: Fair
    Free text: When working out I feel more winded than normal, this has been going on since the shot I just kept forgetting to put it down.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-05-29
    Survey response — 3 months, dose 2
    MedDRA: Dyspnoea — Feeling: Good
    Free text: Still having some shortness of breath
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-08-28
    Survey response — 6 months, dose 2
    MedDRA: Brain fog — Feeling: Fair
    Free text: I Feel like I still have brain fog and it is concerning!!!
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  25. 2022-02-27
    Survey response — 12 months, dose 2
    MedDRA: Wheezing — Feeling: Good
    Free text: Seems like I'm wheezing more. I'm going to see my doctor about it otherwise I'm feeling pretty well.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-31Moderna
22021-02-27Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-03

Systemic reaction (other): I didnt tell on the first day I got headache and sore shoulder where I got the shot. That night very sore shoulder during night that woke me and then sore shoulder but better than during the night.

2021-02-05

Systemic reaction (other): Just have very mild headache. I seldom get headaches so it a little annoying.

2021-02-06

Systemic reaction (other): It has been 6 days and I dont feel normal. Is this anything I should be concerned with?

Release 3 — day 7, dose 1

2021-02-09

Systemic reaction (other): One thing I have had a runny nose for 8 days and some shortness of breath also.

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): I never told you after the first shot I had severe brain fog, Im hoping I dont get it again after shot # 2. It lasted about 3 weeks!

2021-03-02

Systemic reaction (other): Brain fog

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Brain fog

2021-03-04

Systemic reaction (other): Brain fog

2021-03-05

Systemic reaction (other): Still have lingering brain fog

Release 5 — day 7, dose 2

2021-03-06

Systemic reaction (other): Brain fog

Release 6 — day 21, dose 2

2021-03-20

Symptoms: Some brain fog still and some headaches. I never get headaches so thats why Im mentioning it.

Release 6 — day 28, dose 2

2021-03-28

Symptoms: Still have brain fog but also my joints seem to hurt more

Release 7 — day 42, dose 2

2021-04-10

Symptoms: When working out I feel more winded than normal, this has been going on since the shot I just kept forgetting to put it down.

Release 8 — 3 months, dose 2

2021-05-29

Symptoms: Still having some shortness of breath

Release 9 — 6 months, dose 2

2021-08-28

Symptoms: I Feel like I still have brain fog and it is concerning!!!

Release 11 — 12 months, dose 2

2022-02-27

Symptoms: Seems like I'm wheezing more. I'm going to see my doctor about it otherwise I'm feeling pretty well.

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 ✓ ✓ ✓
SDBrain fog ✓ · ✓
SDDyspnoea ✓ ✓ ✓
SDFeeling abnormal ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDUnevaluable event ✓ ✓ ✓
SDWheezing · · ✓
SROArthralgia ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SRORhinorrhoea ✓ ✓ ✓

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

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