5BU-52398-37586
4 vaccinations
5 coded responses
33 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 852 / AZ
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Dose 1 — Moderna
-
2021-01-26
Registered in v-safe
-
2021-01-27
Survey response — days 1–6 daily, dose 1MedDRA: Body temperature increased, Fatigue, Headache, Restlessness — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: In total, I did not have any symptoms until about 7 hours after my shot. Then I had fatigue , a slight headache, restlessness, then an increase of my usual temperature by 1-1/2 degrees. It all lasted for about a day. I feel much better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-01-29
-
2021-01-31
Survey response — days 1–6 daily, dose 1MedDRA: Blood glucose increased — Feeling: Good · Fatigue or tirednessFree text: Day 1-2 my blood sugar level was higher.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-01
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-01
-
2021-03-02
Dose 2 — Moderna
-
2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree text: No, I am doing goodMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-06-03
- 2021-08-31
-
2021-11-02
Dose 3 — Moderna
- 2022-03-02
-
2022-04-13
Dose 4 — Moderna
-
2022-04-26
Survey response — day 7, dose 4MedDRA: Feeling abnormal, Pain in extremity, Somnolence — Feeling: Good · Be unable to do your normal daily activitiesFree text: The evening of my shot I felt poorly, it continued for almost 3 days. My shot arm was sore also. I am better 3 days later. No fever accompanied my shot. During the 3 days I slept more.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
-
2022-05-25
Survey response — day 42, dose 4MedDRA: Cough, Nasopharyngitis, Pre-existing disease, Rhinorrhoea — Feeling: GoodFree text: A moderate cough and cold with runny nose. It may be my allergies acting up. I am better now.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-13
- 2022-10-12
- 2023-04-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | |
| 2 | 2021-03-02 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-04-13 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): In total, I did not have any symptoms until about 7 hours after my shot. Then I had fatigue , a slight headache, restlessness, then an increase of my usual temperature by 1-1/2 degrees. It all lasted for about a day. I feel much better today.
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Day 1-2 my blood sugar level was higher.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): No, I am doing good
Release 11 — day 7, dose 4
Systemic reaction (other): The evening of my shot I felt poorly, it continued for almost 3 days. My shot arm was sore also. I am better 3 days later. No fever accompanied my shot. During the 3 days I slept more.
Release 11 — day 42, dose 4
Symptoms: A moderate cough and cold with runny nose. It may be my allergies acting up. I am better now.
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 | Cough | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Blood glucose increased | ✓ | ✓ | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Restlessness | ✓ | ✓ | ✓ |
| SRO | Somnolence | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release