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574-12207-84173

2 vaccinations 7 coded responses 18 check-ins 7 free-text entries 0 call cases
Sex
Male
Age at first dose
61-65
ZIP prefix
950 / CA
Registered
2021-04-11
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-10
    Dose 1 — Moderna
  2. 2021-04-11
    Registered in v-safe
  3. 2021-04-11
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pyrexia — Feeling: Fair · Fever · Chills, Muscle or body aches
    Free text: Having a bit of feverish feeling though temp is showing around 97.1 to 97.3
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-13
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chills — Feeling: Fair · Chills
    Free text: Mild - slight chill later half of day - but today 3rd day feeling much better than day 2 and much better than day 1 after the vaccine shot 1
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chills — Feeling: Good · Chills
    Free text: Still feel slight chill later part of day, but better day by day
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-17
    Survey response — day 7, dose 1
    MedDRA: Chills — Feeling: Good · Chills
    Free text: Still having Slight chill late afternoon/ early evening
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-24
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  8. 2021-05-01
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-05-11
    Dose 2 — Moderna
  10. 2021-05-11
    Survey response — day 0, dose 2
    MedDRA: Injected limb mobility decreased, Injection site pain — Feeling: Fair · Site: Pain · Fever
    Free text: Pain in the injection area quite significant, and unable to lift hand above hip, limiting activities on that hand
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-05-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  12. 2021-05-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  13. 2021-05-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chills — Feeling: Good · Chills
    Free text: Slight chill late afternoon / evening
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-18
    Survey response — day 7, dose 2
    MedDRA: Chills — Feeling: Good
    Free text: Slight afternoon / evening chill
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-05-25
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-06-02
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-06-08
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-06-15
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-06-22
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-08-12
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-11-12
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-10Moderna
22021-05-11Moderna

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-11

Systemic reaction (other): Having a bit of feverish feeling though temp is showing around 97.1 to 97.3

2021-04-13

Systemic reaction (other): Mild - slight chill later half of day - but today 3rd day feeling much better than day 2 and much better than day 1 after the vaccine shot 1

2021-04-15

Systemic reaction (other): Still feel slight chill later part of day, but better day by day

Release 7 — day 7, dose 1

2021-04-17

Systemic reaction (other): Still having Slight chill late afternoon/ early evening

Release 8 — day 0, dose 2

2021-05-11

Systemic reaction (other): Pain in the injection area quite significant, and unable to lift hand above hip, limiting activities on that hand

Release 8 — days 1–6 daily, dose 2

2021-05-17

Systemic reaction (other): Slight chill late afternoon / evening

Release 8 — day 7, dose 2

2021-05-18

Systemic reaction (other): Slight afternoon / evening chill

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

FieldPreferred term2021-092023-042024-11
SROChills ✓ ✓ ✓
SROInjected limb mobility decreased ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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