5QC-61853-02745
5 vaccinations
7 coded responses
49 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 060 / CT
- Registered
- 2021-02-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-26
Registered in v-safe
-
2021-02-26
Dose 1 — Moderna
- 2021-02-26
- 2021-02-27
-
2021-02-28
Survey response — days 1–6 daily, dose 1MedDRA: Flushing, Injection site pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: Approximately 10 hours after the injection I had some soreness at the injection site (upper arm) and experienced mild flush symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
-
2021-03-19
Survey response — day 21, dose 1MedDRA: Diarrhoea — Feeling: FairFree text: Mild diarrhea for about 12 hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-26
Dose 2 — Moderna
-
2021-03-26
Survey response — day 0, dose 2MedDRA: Injection site pain — Feeling: GoodFree text: Sore arm at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-27
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-09
- 2021-06-26
- 2021-09-24
-
2021-10-28
Dose 3 — Moderna
- 2021-10-29
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Adverse reaction — Feeling: Good · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activitiesFree text: These symptoms occurred 24 hours after receiving the vaccine and cleared up in the next 12 hours.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Nausea — Feeling: Good · NauseaFree text: Little nausea for a few hours this morningMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-10
- 2022-01-29
-
2022-04-01
Dose 4 — Moderna
- 2022-04-19
-
2022-04-24
Survey response — day 21, dose 4MedDRA: Cardiac ablation, Cardiovascular symptom, Pyrexia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Had prior scheduled cardiac ablation on 4/22. Experiencing symptoms from the procedure. Mild fever.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-07-01
-
2022-09-09
Dose 5 — Moderna
- 2022-09-30
- 2022-09-30
- 2022-10-09
- 2022-10-14
- 2022-10-21
- 2022-12-11
-
2023-03-10
Survey response — 6 months, dose 5MedDRA: Pyrexia, Respiratory tract congestion, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-26 | Moderna | |
| 2 | 2021-03-26 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-04-01 | Moderna | No |
| 5 | 2022-09-09 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Approximately 10 hours after the injection I had some soreness at the injection site (upper arm) and experienced mild flush symptoms.
Release 6 — day 21, dose 1
Symptoms: Mild diarrhea for about 12 hours.
Release 6 — day 0, dose 2
Systemic reaction (other): Sore arm at injection site
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): These symptoms occurred 24 hours after receiving the vaccine and cleared up in the next 12 hours.
Systemic reaction (other): Little nausea for a few hours this morning
Release 11 — day 21, dose 4
Symptoms: Had prior scheduled cardiac ablation on 4/22. Experiencing symptoms from the procedure. Mild fever.
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 | Cardiac ablation | · | · | ✓ |
| SD | Cardiovascular symptom | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Flushing | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Nausea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release