4YE-31045-71569
2 vaccinations
9 coded responses
26 check-ins
9 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 483 / MI
- Registered
- 2021-03-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-12
Registered in v-safe
-
2021-03-12
Dose 1 — Moderna
- 2021-03-12
-
2021-03-13
Survey response — days 1–6 daily, dose 1MedDRA: Ageusia, Anosmia, Headache — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: I had COVID-19 last August - headaches, loss of sense of smell and taste have been ongoingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Tinnitus — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, DiarrheaFree text: Headache and ringing in ears are probably related to having past Covid-19MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: Good · Site: Redness · Fatigue or tirednessFree text: As I have noted some symptoms relate back to when I had COVID-19- the tiredness today has been less and back to normal. I have scheduled my second shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: No symptoms that I attribute to the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-17
-
2021-03-18
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: GoodFree text: There are none related by me to the vaccine. I do have ongoing symptoms which I relate to having had COVID-19.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-19
Survey response — day 7, dose 1MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: I believe the rash which has existed prior to the vaccine is related to having had COVID-19 which is why I have not mentioned it beforeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
- 2021-04-02
-
2021-04-09
Dose 2 — Moderna
- 2021-04-09
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-04-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to workAdult check-in
-
2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Headache, Tinnitus — Feeling: Good · Muscle or body achesFree text: I have had a lower backache since the day after my shot. Had not had a backache before. I have ringing in my ears and headaches which I attribute to my having had Covid19 several months agoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Good · Muscle or body achesFree text: Still have lower back pain - it started after the shot but I can't state that it was caused by the shot. Otherwise I am ok.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-14
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Good · Headache, Muscle or body achesFree text: The only symptom possibly related to the shot is lower back pain which manifested post shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-07-09
- 2021-10-08
- 2022-04-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna | |
| 2 | 2021-04-09 | Moderna |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): I had COVID-19 last August - headaches, loss of sense of smell and taste have been ongoing
Systemic reaction (other): Headache and ringing in ears are probably related to having past Covid-19
Systemic reaction (other): As I have noted some symptoms relate back to when I had COVID-19- the tiredness today has been less and back to normal. I have scheduled my second shot.
Systemic reaction (other): No symptoms that I attribute to the vaccine
Systemic reaction (other): There are none related by me to the vaccine. I do have ongoing symptoms which I relate to having had COVID-19.
Release 5 — day 7, dose 1
Systemic reaction (other): I believe the rash which has existed prior to the vaccine is related to having had COVID-19 which is why I have not mentioned it before
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I have had a lower backache since the day after my shot. Had not had a backache before. I have ringing in my ears and headaches which I attribute to my having had Covid19 several months ago
Systemic reaction (other): Still have lower back pain - it started after the shot but I can't state that it was caused by the shot. Otherwise I am ok.
Systemic reaction (other): The only symptom possibly related to the shot is lower back pain which manifested post shot.
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 |
|---|---|---|---|---|
| SRO | Ageusia | ✓ | ✓ | ✓ |
| SRO | Anosmia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release