5GV-16213-83509
2 vaccinations
3 coded responses
24 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 31-35
- ZIP prefix
- 029 / RI
- Registered
- 2021-04-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-06
Registered in v-safe
-
2021-04-06
Dose 1 — Moderna
- 2021-04-06
-
2021-04-07
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-04-08
- 2021-04-09
- 2021-04-12
- 2021-04-13
- 2021-04-22
- 2021-04-27
-
2021-05-04
Dose 2 — Moderna
- 2021-05-04
-
2021-05-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-05-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-05-07
- 2021-05-08
- 2021-05-09
- 2021-05-10
- 2021-05-11
- 2021-05-20
- 2021-05-25
- 2021-06-01
-
2021-06-08
Survey response — day 35, dose 2MedDRA: Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea — Feeling: FairFree text: Runny nose, nasal congestion, sore throat have a cold & toddler has a diagnosed upper respiratory infection (COVID negative).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-16
Survey response — day 42, dose 2MedDRA: Nasopharyngitis, SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I have a cold, upper respiratory infection. I tested negative for COVID (rapid & PCR). Going through our whole house, including 2 young kids in daycare (also tested negative for COVID).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-03
- 2021-11-02
-
2022-05-06
Survey response — 12 months, dose 2MedDRA: Cough, Exposure to SARS-CoV-2, Fatigue, Headache, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Currently have a COVID case in my household (<5, not vaccinated). Experiencing COVID symptoms (runny nose, congestion, headache, fatigue, some cough). Getting a PCR test this afternoon.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-06 | Moderna | |
| 2 | 2021-05-04 | Moderna |
Free text
Release 8 — day 35, dose 2
Symptoms: Runny nose, nasal congestion, sore throat have a cold & toddler has a diagnosed upper respiratory infection (COVID negative).
Release 9 — day 42, dose 2
Symptoms: I have a cold, upper respiratory infection. I tested negative for COVID (rapid & PCR). Going through our whole house, including 2 young kids in daycare (also tested negative for COVID).
Release 11 — 12 months, dose 2
Symptoms: Currently have a COVID case in my household (<5, not vaccinated). Experiencing COVID symptoms (runny nose, congestion, headache, fatigue, some cough). Getting a PCR test this afternoon.
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 | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Upper respiratory tract infection | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release