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5PZ-52380-56249

1 vaccination 3 coded responses 7 check-ins 3 free-text entries 0 call cases
Sex
Male
Age at first dose
61-65
ZIP prefix
992 / WA
Registered
2021-01-28
Relationship
Self
Race
N/A
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-28
    Registered in v-safe
  2. 2021-01-28
    Dose 1 — Moderna
  3. 2021-01-29
    Survey response — days 1–6 daily, dose 1
    MedDRA: Energy increased, Injection site pain, Injection site pruritus, Vertigo — Feeling: Good · Site: Pain, Itching
    Free text: I experienced a slight degree of vertigo, for about 2 hours, following my vaccination. I also experienced mild pai/itching, at the injection site as well as experiencing elevated energy(no;tachycardia/elevated heart rate, or change in my diastolic/systolic bp). The energy that i experienced, was analogous to a massive adrenaline rush, which i am still experiencing.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-31
    Survey response — days 1–6 daily, dose 1
    MedDRA: Abdominal pain upper, Flatulence — Feeling: Good
    Free text: Slight degree of gastrointestinal discomfort, gas and cramps, as i previously mentioned yesterday. Symptoms have improved significantly.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-06
    Health check-in — day 7, dose 1
    Feeling: Fair · Abdominal pain
    Adult check-in
  7. 2021-02-13
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  8. 2021-02-18
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-07-29
    Survey response — 6 months, dose 1
    MedDRA: Asthenia, Benign prostatic hyperplasia, Colitis, Dizziness, Dysuria, Muscle spasms, Musculoskeletal pain, Vertigo, Weight decreased — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Colitis. Benign Prostate Hyperplasia. Musculoskeletal pain cramping massive weight loss. Difficulty urinating vertigo dizziness weakness. Lack of energy
    MedDRA releases: 2021-09,2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-28Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): I experienced a slight degree of vertigo, for about 2 hours, following my vaccination. I also experienced mild pai/itching, at the injection site as well as experiencing elevated energy(no;tachycardia/elevated heart rate, or change in my diastolic/systolic bp). The energy that i experienced, was analogous to a massive adrenaline rush, which i am still experiencing.

2021-01-31

Systemic reaction (other): Slight degree of gastrointestinal discomfort, gas and cramps, as i previously mentioned yesterday. Symptoms have improved significantly.

Release 9 — 6 months, dose 1

2021-07-29

Symptoms: Colitis. Benign Prostate Hyperplasia. Musculoskeletal pain cramping massive weight loss. Difficulty urinating vertigo dizziness weakness. Lack of energy

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
SDAsthenia ✓ · ✓
SDBenign prostatic hyperplasia ✓ · ✓
SDColitis ✓ · ✓
SDDizziness ✓ · ✓
SDDysuria ✓ · ✓
SDMuscle spasms ✓ · ✓
SDMusculoskeletal pain ✓ · ✓
SDVertigo ✓ · ✓
SDWeight decreased ✓ · ✓
SROAbdominal pain upper ✓ ✓ ✓
SROEnergy increased ✓ ✓ ✓
SROFlatulence ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROInjection site pruritus ✓ ✓ ✓
SROVertigo ✓ ✓ ✓

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