5GN-30617-05397
3 vaccinations
12 coded responses
43 check-ins
12 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 105 / NY
- Registered
- 2021-03-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Dose 1 — Janssen/Johnson & Johnson
-
2021-03-12
Registered in v-safe
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2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Pollakiuria — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Increased need to urinateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
-
2021-03-26
Survey response — day 14, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Mild soreness at injection site only one or two days the past week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-06-10
- 2021-09-09
-
2021-12-23
Dose 2 — Moderna
-
2021-12-24
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-12-25
-
2021-12-26
Survey response — days 1–6 daily, dose 2MedDRA: Pollakiuria — Feeling: Good · Site: PainFree text: Slight increase in urinationMedDRA releases: 2024-11 · check-in free text available
-
2021-12-27
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain, Pollakiuria — Feeling: Good · Site: PainFree text: Slight increase in urination. Short duration of colic.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-28
Survey response — days 1–6 daily, dose 2MedDRA: Pollakiuria — Feeling: Good · Site: PainFree text: Slight increase in urinationMedDRA releases: 2024-11 · check-in free text available
- 2021-12-29
- 2021-12-30
- 2022-01-06
-
2022-01-13
Survey response — day 21, dose 2MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Positive test for COVID19MedDRA releases: 2024-11 · check-in free text available
- 2022-01-20
- 2022-01-27
- 2022-02-03
- 2022-03-24
- 2022-06-23
-
2022-09-25
Dose 3 — Moderna
- 2022-09-25
- 2022-09-26
-
2022-09-27
Survey response — days 1–6 daily, dose 3MedDRA: Flatulence — Feeling: Good · Site: PainFree text: Gas, lasting several hoursMedDRA releases: 2024-11 · check-in free text available
-
2022-09-28
Survey response — days 1–6 daily, dose 3MedDRA: Flatulence — Feeling: GoodFree text: Mild gasMedDRA releases: 2024-11 · check-in free text available
- 2022-09-29
-
2022-09-30
Survey response — days 1–6 daily, dose 3MedDRA: Flatulence, Pollakiuria — Feeling: Good · NauseaFree text: Mild gas, slight increase in urinary frequency.MedDRA releases: 2024-11 · check-in free text available
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2022-10-01
Survey response — days 1–6 daily, dose 3MedDRA: Body temperature increased, Pollakiuria — Feeling: GoodFree text: Temperature elevated to 98.9 for about 6 hours. Increase in urinary frequency.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-02
- 2022-10-09
- 2022-10-16
- 2022-10-23
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2022-10-30
Survey response — day 35, dose 3MedDRA: Benign prostatic hyperplasia, Urinary tract disorder, Vomiting — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Urinary symptoms due to BPH. Urine culture was negative; referred to urologist for follow up, including prescription medications.MedDRA releases: 2024-11 · check-in free text available
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2022-10-30
Report sent to call center — day 35, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-01
- 2022-11-02
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2022-11-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-06
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2022-12-25
Health check-in — 3 months, dose 3Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Prostate CancerAdult check-in · check-in free text available
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2022-12-25
Call case (no matching report) — SuccessfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-12-28
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2023-03-26
Survey response — 6 months, dose 3MedDRA: Medical counselling, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-03-26
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-03-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Janssen/Johnson & Johnson | |
| 2 | 2021-12-23 | Moderna | No |
| 3 | 2022-09-25 | Moderna | No |
Call center
3 call center cases
2 successful · 1 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Increased need to urinate
Release 6 — day 14, dose 1
Symptoms: Mild soreness at injection site only one or two days the past week.
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): Slight increase in urination
Systemic reaction (other): Slight increase in urination. Short duration of colic.
Systemic reaction (other): Slight increase in urination
Release 10 — day 21, dose 2
Symptoms: Positive test for COVID19
Release 12 — days 1–6 daily, dose 3
Systemic reaction (other): Gas, lasting several hours
Systemic reaction (other): Mild gas
Systemic reaction (other): Mild gas, slight increase in urinary frequency.
Systemic reaction (other): Temperature elevated to 98.9 for about 6 hours. Increase in urinary frequency.
Release 12 — day 35, dose 3
Symptoms: Urinary symptoms due to BPH. Urine culture was negative; referred to urologist for follow up, including prescription medications.
Release 12 — 3 months, dose 3
Symptoms: Prostate Cancer
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 |
|---|---|---|---|---|
| HCVO | Medical counselling | · | · | ✓ |
| SD | Benign prostatic hyperplasia | · | · | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Urinary tract disorder | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Abdominal pain | · | · | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Flatulence | · | · | ✓ |
| SRO | Pollakiuria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release