54B-67941-80272
4 vaccinations
6 coded responses
44 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 921 / CA
- Registered
- 2021-02-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-01
Registered in v-safe
-
2021-02-01
Dose 1 — Moderna
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
-
2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Migraine — Feeling: Good · Headache · Be unable to do your normal daily activitiesFree text: Headache is probably a migraineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-03
- 2021-03-08
-
2021-03-10
Dose 2 — Moderna
- 2021-03-15
- 2021-03-17
- 2021-03-24
-
2021-03-31
Survey response — day 21, dose 2MedDRA: Abdominal discomfort, Dyspepsia — Feeling: GoodFree text: Have had some stomach discomfort, mild indigestion after eating. No fever, chills or vomiting. Goes away after about two hours but has come back after eating again.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
-
2021-04-14
Survey response — day 35, dose 2MedDRA: Headache, Migraine, Nausea — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Very bad headache along upper front of face. Some nausea but no vomiting. Probably a Migrain. Slept for 4 hours and woke feeling a little better.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
-
2021-06-09
Survey response — 3 months, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: Not Covid related so not providing information.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-09-08
-
2021-10-28
Dose 3 — Pfizer-BioNTech
- 2021-10-28
- 2021-10-29
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-31
- 2021-11-01
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fever · Headache, Fatigue or tirednessAdult check-in
-
2021-11-04
Survey response — day 7, dose 3MedDRA: Cough — Feeling: Fair · Fever · Fatigue or tirednessFree text: Dry coughMedDRA releases: 2024-11 · check-in free text available
- 2021-11-12
- 2021-11-18
- 2021-11-25
- 2021-12-02
-
2021-12-09
Survey response — day 42, dose 3MedDRA: Gluten sensitivity, Headache — Feeling: FairFree text: Headache, probably sugar related.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-27
-
2022-04-21
Dose 4 — Moderna
- 2022-04-28
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-19
- 2022-05-26
- 2022-06-03
- 2022-07-21
- 2022-10-20
- 2023-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-01 | Moderna | |
| 2 | 2021-03-10 | Moderna | |
| 3 | 2021-10-28 | Pfizer-BioNTech | No |
| 4 | 2022-04-21 | Moderna | No |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Headache is probably a migraine
Release 6 — day 21, dose 2
Symptoms: Have had some stomach discomfort, mild indigestion after eating. No fever, chills or vomiting. Goes away after about two hours but has come back after eating again.
Release 7 — day 35, dose 2
Symptoms: Very bad headache along upper front of face. Some nausea but no vomiting. Probably a Migrain. Slept for 4 hours and woke feeling a little better.
Release 9 — 3 months, dose 2
Symptoms: Not Covid related so not providing information.
Release 10 — day 7, dose 3
Systemic reaction (other): Dry cough
Release 10 — day 42, dose 3
Symptoms: Headache, probably sugar related.
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 | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Dyspepsia | ✓ | ✓ | ✓ |
| SD | Gluten sensitivity | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Migraine | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Headache | ○ | ✓ | ○ |
| SRO | Migraine | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release