523-69156-12836
5 vaccinations
4 coded responses
56 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 665 / KS
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-02
Registered in v-safe
-
2021-03-02
Dose 1 — Moderna
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
-
2021-03-16
Survey response — day 14, dose 1MedDRA: Erythema, Inflammation, Pain in extremity, Pruritus — Feeling: GoodFree text: I had covered arm. I had no idea what it was I looked it up. It was pretty inflamed itchy sore red. It started on day 8 which was last Wednesday and today it seems to be gone or at least I hope just a little bit of itchiness I think.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
-
2021-03-30
Dose 2 — Moderna
-
2021-03-30
Survey response — day 0, dose 2MedDRA: Pruritus — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tirednessFree text: Some itching behind my ear but that could be from something else. I swear that my original site on the other side of where today's was given was was itchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-31
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tirednessAdult check-in
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · HeadacheAdult check-in
- 2021-04-03
-
2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Atrial fibrillation, Headache — Feeling: Fair · HeadacheFree text: I'm guessing that I don't feel well on my headache is because I started afib this morning. I am being treated for AFib on a regular basis.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-06-29
-
2021-09-28
Survey response — 6 months, dose 2MedDRA: Back disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I would not think it has anything to do with my vaccine but I've had some upper back problems which I've had not had quite the same way before. Hopefully some of the doctors will get that figured out.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-28
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-09-30
-
2021-10-25
Dose 3 — Moderna
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tirednessAdult check-in
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tirednessAdult check-in
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
- 2022-04-25
-
2022-04-29
Dose 4 — Moderna
- 2022-04-29
- 2022-04-30
-
2022-05-01
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-05-02
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-07-29
-
2022-09-20
Dose 5 — ModernaCo-administered: Tetanus
- 2022-10-19
- 2022-10-25
- 2022-11-01
- 2022-12-20
- 2023-03-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-29 | Moderna | No |
| 5 | 2022-09-20 | Moderna | Tetanus |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — day 14, dose 1
Symptoms: I had covered arm. I had no idea what it was I looked it up. It was pretty inflamed itchy sore red. It started on day 8 which was last Wednesday and today it seems to be gone or at least I hope just a little bit of itchiness I think.
Release 6 — day 0, dose 2
Systemic reaction (other): Some itching behind my ear but that could be from something else. I swear that my original site on the other side of where today's was given was was itching
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): I'm guessing that I don't feel well on my headache is because I started afib this morning. I am being treated for AFib on a regular basis.
Release 9 — 6 months, dose 2
Symptoms: I would not think it has anything to do with my vaccine but I've had some upper back problems which I've had not had quite the same way before. Hopefully some of the doctors will get that figured out.
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 | Back disorder | · | · | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Inflammation | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SRO | Atrial fibrillation | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release