4ZR-71854-30606
2 vaccinations
9 coded responses
17 check-ins
9 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 458 / OH
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Registered in v-safe
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2021-03-04
Dose 1 — Moderna
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2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Pyrexia — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: My fever broke sometime early AM before I wokeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: Redness, SwellingFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Site: Redness, Swelling · Rash, not including the immediate area around the injection siteFree text: Developed rash in both legs from calf to ankles all the way around but no swelling or itchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Site: Redness, Swelling · Rash, not including the immediate area around the injection siteFree text: Lower leg rash both legs as stated yesterday. No change...MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-09
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Site: RednessFree text: Still have a rash that hasnt subsided at all on both lower legs....MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: GoodFree text: Rash in both legs as previously stated with NO improvement!!?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Survey response — day 7, dose 1MedDRA: Rash — Feeling: GoodFree text: Rash on lower legs.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
- 2021-03-25
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2021-04-01
Dose 2 — Moderna
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2021-04-01
Survey response — day 0, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: PainFree text: Its too early after shot..MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Pain, Pyrexia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: The fever and chills were last night, 9 hours after the shot. Today is all of the aches and pains. I had the exact same reaction with first shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): My fever broke sometime early AM before I woke
Systemic reaction (other): No
Systemic reaction (other): Developed rash in both legs from calf to ankles all the way around but no swelling or itching
Systemic reaction (other): Lower leg rash both legs as stated yesterday. No change...
Systemic reaction (other): Still have a rash that hasnt subsided at all on both lower legs....
Systemic reaction (other): Rash in both legs as previously stated with NO improvement!!?
Release 5 — day 7, dose 1
Systemic reaction (other): Rash on lower legs.
Release 6 — day 0, dose 2
Systemic reaction (other): Its too early after shot..
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): The fever and chills were last night, 9 hours after the shot. Today is all of the aches and pains. I had the exact same reaction with first 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 | Chills | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release