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57Z-26380-88281

2 vaccinations 6 coded responses 20 check-ins 6 free-text entries 0 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
984 / WA
Registered
2021-02-11
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-11
    Registered in v-safe
  2. 2021-02-11
    Dose 1 — Moderna
  3. 2021-02-11
    Health check-in — day 0, dose 1
    Feeling: Good · Diarrhea
    Adult check-in
  4. 2021-02-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Feeling cold — Feeling: Fair · Chills
    Free text: Chilled easier outside- during the big Chill. Somewhat bad timing during this season influx. However I didnt want to pass over first vaccine opportunities!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: No adverse event — Feeling: Good
    Free text: None
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Somnolence — Feeling: Good
    Free text: Sleepy : not sure if heavy snow is a psychosomatic issue?
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-18
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-25
    Health check-in — day 14, dose 1
    Feeling: Fair
    Adult check-in
  10. 2021-03-05
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-11
    Dose 2 — Moderna
  12. 2021-03-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  13. 2021-03-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Nausea · Be unable to work
    Adult check-in
  14. 2021-03-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness · Be unable to work
    Adult check-in
  15. 2021-03-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Somnolence — Feeling: Good
    Free text: Afternoon naps needed
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-18
    Survey response — day 7, dose 2
    MedDRA: Depression — Feeling: Good
    Free text: Technically depressed this NW season along with strict democratic states...
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-25
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-04-01
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-04-08
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-04-15
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-04-22
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-06-10
    Survey response — 3 months, dose 2
    MedDRA: Muscle spasms, Office visit, Spinal pain, Stress — Feeling: Poor · Be unable to work
    Free text: Extreme spinal pain or shoulder muscle spasms! Starting progressively June 3, 2021. Checked into primary care on 06/ 08 /2021. Stress to roll out of bed. Could be a delayed adverse effect from second Modera Vac? ARNP did know for sure...
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-09-11
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-11Moderna
22021-03-11Moderna

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-12

Systemic reaction (other): Chilled easier outside- during the big Chill. Somewhat bad timing during this season influx. However I didnt want to pass over first vaccine opportunities!

2021-02-14

Systemic reaction (other): None

2021-02-15

Systemic reaction (other): Sleepy : not sure if heavy snow is a psychosomatic issue?

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): Afternoon naps needed

Release 5 — day 7, dose 2

2021-03-18

Systemic reaction (other): Technically depressed this NW season along with strict democratic states...

Release 9 — 3 months, dose 2

2021-06-10

Symptoms: Extreme spinal pain or shoulder muscle spasms! Starting progressively June 3, 2021. Checked into primary care on 06/ 08 /2021. Stress to roll out of bed. Could be a delayed adverse effect from second Modera Vac? ARNP did know for sure...

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
SDMuscle spasms ✓ ✓ ✓
SDOffice visit ✓ ✓ ✓
SDSpinal pain ✓ ✓ ✓
SDStress ✓ ✓ ✓
SRODepression ✓ ✓ ✓
SROFeeling cold ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓
SROSomnolence ✓ ✓ ✓

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

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