5LN-32699-82373
1 vaccination
5 coded responses
10 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 826 / WY
- Registered
- 2021-01-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Dose 1 — Moderna
-
2021-01-04
Registered in v-safe
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2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising, Injection site discolouration — Feeling: Good · Site: Redness, Itching · HeadacheFree text: Slight 1" x 1" purple bruise below shot yesterday, greenish and size of a quarter todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-06
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2021-01-13
Survey response — day 14, dose 1MedDRA: Cough, Injection site erythema, Injection site pruritus, Rhinorrhoea — Feeling: FairFree text: Slight cough, slight runny nose, 2 inch square red mark at injection site. It stopped itching 2 days ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-20
Survey response — day 21, dose 1MedDRA: COVID-19, Ear congestion, Headache, Pyrexia, Sinus disorder — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: I have covid.Cough, stuffy ears and sinuses, slight headache comes and goes, slight fever off and on Sunday and Monday and maybe Tuesday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-27
Survey response — day 28, dose 1MedDRA: Cough, Fatigue, Hypersomnia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Cough got a lot worse, like bronchitis type of cough. Got super fatigued. Slept most of 3 days. Still tired, but not as bad. Cough is more frequent now, but not as deep. Easier to breath today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-03
- 2021-02-10
- 2021-03-31
- 2021-06-30
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2021-12-30
Survey response — 12 months, dose 1MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Pharyngeal swelling, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sore & swollen throat, runny nose, cough. No fever. Just a cold that my 3 year old and toddler nephews had on Christmas Day. They were sick for three days and are on the mend now. This is my third day and symptoms are lessening.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Slight 1" x 1" purple bruise below shot yesterday, greenish and size of a quarter today
Release 1 — day 14, dose 1
Symptoms: Slight cough, slight runny nose, 2 inch square red mark at injection site. It stopped itching 2 days ago.
Release 2 — day 21, dose 1
Symptoms: I have covid.Cough, stuffy ears and sinuses, slight headache comes and goes, slight fever off and on Sunday and Monday and maybe Tuesday.
Release 2 — day 28, dose 1
Symptoms: Cough got a lot worse, like bronchitis type of cough. Got super fatigued. Slept most of 3 days. Still tired, but not as bad. Cough is more frequent now, but not as deep. Easier to breath today.
Release 10 — 12 months, dose 1
Symptoms: Sore & swollen throat, runny nose, cough. No fever. Just a cold that my 3 year old and toddler nephews had on Christmas Day. They were sick for three days and are on the mend now. This is my third day and symptoms are lessening.
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 | COVID-19 | ✓ | ✓ | ✓ |
| SD | Ear congestion | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hypersomnia | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pharyngeal swelling | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sinus disorder | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Injection site discolouration | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release