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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

  1. 2020-12-30
    Dose 1 — Moderna
  2. 2021-01-04
    Registered in v-safe
  3. 2021-01-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site bruising, Injection site discolouration — Feeling: Good · Site: Redness, Itching · Headache
    Free text: Slight 1" x 1" purple bruise below shot yesterday, greenish and size of a quarter today
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-06
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-01-13
    Survey response — day 14, dose 1
    MedDRA: Cough, Injection site erythema, Injection site pruritus, Rhinorrhoea — Feeling: Fair
    Free 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
  6. 2021-01-20
    Survey response — day 21, dose 1
    MedDRA: COVID-19, Ear congestion, Headache, Pyrexia, Sinus disorder — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities
    Free 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
  7. 2021-01-27
    Survey response — day 28, dose 1
    MedDRA: Cough, Fatigue, Hypersomnia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities
    Free 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
  8. 2021-02-03
    Health check-in — day 35, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-02-10
    Health check-in — day 42, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-03-31
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-06-30
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-12-30
    Survey response — 12 months, dose 1
    MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Pharyngeal swelling, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free 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

DoseDateManufacturerCo-administered
12020-12-30Moderna

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-04

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

2021-01-13

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

2021-01-20

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

2021-01-27

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

2021-12-30

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

FieldPreferred term2021-092023-042024-11
SDCough ✓ ✓ ✓
SDCOVID-19 ✓ ✓ ✓
SDEar congestion ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDHypersomnia ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site pruritus ✓ ✓ ✓
SDNasopharyngitis · · ✓
SDOropharyngeal pain · · ✓
SDPharyngeal swelling · · ✓
SDPyrexia ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓
SDSinus disorder ✓ ✓ ✓
SROInjection site bruising ✓ ✓ ✓
SROInjection site discolouration ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release