55C-25873-08466
2 vaccinations
4 coded responses
11 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 26-30
- ZIP prefix
- 532 / WI
- Registered
- 2021-05-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-12
Dose 1 — Moderna
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2021-05-10
Dose 2 — Moderna
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2021-05-14
Registered in v-safe
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2021-05-14
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
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2021-05-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-05-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-17
Health check-in — day 7, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-26
- 2021-05-31
- 2021-06-09
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2021-06-14
Survey response — day 35, dose 2MedDRA: Abdominal pain upper, Anosmia, Pain in extremity — Feeling: FairFree text: Stomachache and change of smell, but not a change in how coffee or food smells, just something that I didnt smell before. Minor arm pain in forearm, as if from overwork but no causeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-22
Survey response — day 42, dose 2MedDRA: Fatigue, Sensory disturbance, Sleep paralysis — Feeling: FairFree text: Internal vibrations, fatigue, sleep paralysis phenomenaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-13
Survey response — 3 months, dose 2MedDRA: Emotional disorder, Muscle spasms, Tic — Feeling: FairFree text: Muscle spasms/ticks. Changes in expressionMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-11-11
Survey response — 6 months, dose 2MedDRA: Dysuria, Fatigue, Illusion, Muscle spasms, Neuralgia, Tremor, Vision blurred — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Muscle spasms/tremors of levator labii superioris alaeque nasi and occipitofrontalis. Trouble focusing eyes. Difficulty urinating. Nerve pain throughout body. Change in perception. Unexpected fatigue.MedDRA releases: 2024-11 · check-in free text available
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2021-11-11
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-12 | Moderna | |
| 2 | 2021-05-10 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 9 — day 35, dose 2
Symptoms: Stomachache and change of smell, but not a change in how coffee or food smells, just something that I didnt smell before. Minor arm pain in forearm, as if from overwork but no cause
Release 9 — day 42, dose 2
Symptoms: Internal vibrations, fatigue, sleep paralysis phenomena
Release 9 — 3 months, dose 2
Symptoms: Muscle spasms/ticks. Changes in expression
Release 10 — 6 months, dose 2
Symptoms: Muscle spasms/tremors of levator labii superioris alaeque nasi and occipitofrontalis. Trouble focusing eyes. Difficulty urinating. Nerve pain throughout body. Change in perception. Unexpected fatigue.
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 pain upper | ✓ | ✓ | ✓ |
| SD | Anosmia | ✓ | ✓ | ✓ |
| SD | Dysuria | · | · | ✓ |
| SD | Emotional disorder | ✓ | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Illusion | · | · | ✓ |
| SD | Muscle spasms | ✓ | · | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Sensory disturbance | ✓ | ✓ | ✓ |
| SD | Sleep paralysis | ✓ | ✓ | ✓ |
| SD | Tic | ✓ | · | ✓ |
| SD | Tremor | · | · | ✓ |
| SD | Vision blurred | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release