53P-27083-89056
4 vaccinations
9 coded responses
41 check-ins
9 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 985 / WA
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-10
Registered in v-safe
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2021-03-10
Dose 1 — Moderna
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2021-03-10
Survey response — day 0, dose 1MedDRA: No adverse event — Feeling: GoodFree text: Not at this time. Vaccination was 3.5 hours ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
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2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: PainFree text: Just simply Old Age.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-24
- 2021-03-31
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2021-04-07
Dose 2 — Moderna
- 2021-04-07
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2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-04-09
Survey response — days 1–6 daily, dose 2MedDRA: Balance disorder, Dysstasia, Feeling abnormal, Sleep disorder — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tirednessFree text: Yesterday I got up three times during the night. At 4am I could hardly stand up when getting out of bed and experienced loss of proper balance & bad mind fog.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
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2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Asthenia, Lymph node pain — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Lymph Nodes causing pain and loss of strength in right arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Injected limb mobility decreased, Muscular weakness, Pain in extremity — Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Right arm still hurts and has limited motion since the 2nd Covid Vaccination. Hope it goes away as it is painful and made my right arm weak.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Mobility decreased, Muscular weakness, Pain in extremity — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Right arm still weaker than normal with limited motion & pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Survey response — day 7, dose 2MedDRA: Adverse reaction — Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Right arm has still not made it back to normal condition. Prior to 2nd vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-07-07
- 2021-10-07
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2021-11-09
Dose 3 — Moderna
- 2022-04-07
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2022-05-06
Dose 4 — Pfizer-BioNTech
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2022-05-07
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-05-08
- 2022-05-09
- 2022-05-10
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2022-05-11
Survey response — days 1–6 daily, dose 4MedDRA: Reaction to previous exposure to any vaccine — Feeling: GoodFree text: The Pfizer Booster was much easier on me than any of the Moderna vaccinations have been.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-12
- 2022-05-13
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2022-05-20
Survey response — day 14, dose 4MedDRA: Unevaluable event — Feeling: FairFree text: Nothing to do with Covid. Think I have a UTI.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-08-05
- 2022-11-04
- 2023-05-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Moderna | |
| 2 | 2021-04-07 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
| 4 | 2022-05-06 | Pfizer-BioNTech | No |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Not at this time. Vaccination was 3.5 hours ago.
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Just simply Old Age.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Yesterday I got up three times during the night. At 4am I could hardly stand up when getting out of bed and experienced loss of proper balance & bad mind fog.
Systemic reaction (other): Lymph Nodes causing pain and loss of strength in right arm.
Systemic reaction (other): Right arm still hurts and has limited motion since the 2nd Covid Vaccination. Hope it goes away as it is painful and made my right arm weak.
Systemic reaction (other): Right arm still weaker than normal with limited motion & pain.
Release 7 — day 7, dose 2
Systemic reaction (other): Right arm has still not made it back to normal condition. Prior to 2nd vaccination.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): The Pfizer Booster was much easier on me than any of the Moderna vaccinations have been.
Release 11 — day 14, dose 4
Symptoms: Nothing to do with Covid. Think I have a UTI.
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 | Unevaluable event | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Balance disorder | ✓ | ✓ | ✓ |
| SRO | Dysstasia | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Injected limb mobility decreased | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Mobility decreased | ✓ | ✓ | ✓ |
| SRO | Muscular weakness | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release