5FE-16634-06314
2 vaccinations
6 coded responses
15 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 750 / TX
- Registered
- 2021-01-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-11
Dose 1 — Moderna
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2021-01-19
Registered in v-safe
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2021-01-20
Health check-in — day 7, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-01-25
- 2021-02-01
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2021-02-10
Dose 2 — Moderna
- 2021-02-10
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2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Muscle or body achesAdult check-in
- 2021-02-13
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2021-02-15
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteFree text: Itching on my vaccinated arm above my elbow.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
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2021-02-26
Survey response — day 14, dose 2MedDRA: Muscular weakness — Feeling: GoodFree text: Muscle weakness in my legs inspite of riding of my stationary bike a half hour daily.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — day 21, dose 2MedDRA: Arthralgia, Myalgia, Pain in extremity — Feeling: GoodFree text: Muscle aches in shoulders and armsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Survey response — day 35, dose 2MedDRA: Arthralgia, Chest pain, Loss of personal independence in daily activities, Painful respiration — Feeling: Fair · Be unable to do your normal daily activitiesFree text: In the AM I felt some chest pain on my left side when breathing deeply for a little while . Also, my left hip began bothering during the day enough to cause me to cancel my afternoon walk.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Survey response — day 42, dose 2MedDRA: Arthralgia — Feeling: Good · Be unable to do your normal daily activitiesFree text: My chronic hip pain is increasing and Im sure the steroid injection received in 09/20 is finally losing its effect.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-12
Survey response — 3 months, dose 2MedDRA: Chest pain — Feeling: GoodFree text: I feel an occasional chest painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-12
- 2022-02-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-10 | Moderna |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Itching on my vaccinated arm above my elbow.
Release 4 — day 14, dose 2
Symptoms: Muscle weakness in my legs inspite of riding of my stationary bike a half hour daily.
Release 5 — day 21, dose 2
Symptoms: Muscle aches in shoulders and arms
Release 5 — day 35, dose 2
Symptoms: In the AM I felt some chest pain on my left side when breathing deeply for a little while . Also, my left hip began bothering during the day enough to cause me to cancel my afternoon walk.
Release 6 — day 42, dose 2
Symptoms: My chronic hip pain is increasing and Im sure the steroid injection received in 09/20 is finally losing its effect.
Release 8 — 3 months, dose 2
Symptoms: I feel an occasional chest pain
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SD | Muscular weakness | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Painful respiration | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release