5WA-13489-96284
3 vaccinations
6 coded responses
40 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 902 / CA
- Registered
- 2021-02-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-25
Registered in v-safe
-
2021-02-25
Dose 1 — Moderna
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
-
2021-03-02
Survey response — days 1–6 daily, dose 1MedDRA: Diarrhoea — Feeling: Good · DiarrheaFree text: I dont think the diarrhea was vaccine related I believe it was related to something I ateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-04
- 2021-03-11
-
2021-03-18
Survey response — day 21, dose 1MedDRA: Abdominal discomfort — Feeling: GoodFree text: I had a feeling Ive been upset stomach and Wednesday evening through Thursday Friday clearing up on SundayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-25
Dose 2 — Moderna
- 2021-03-25
-
2021-03-26
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, RednessFree text: Question can the virus affect seizure medication or cause a seizure of breakthrough or do you have any reports on this happenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-27
Survey response — days 1–6 daily, dose 2MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Redness, SwellingFree text: Swelling in the armpit of the left arm where the injection was given not too badMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-28
Survey response — days 1–6 daily, dose 2MedDRA: Oedema peripheral — Feeling: Good · Site: Pain, Redness, Swelling · Joint painsFree text: Swelling in armpit areaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-03-30
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · HeadacheAdult check-in
- 2021-03-31
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-06-27
- 2021-09-23
-
2022-03-08
Dose 3 — Moderna
- 2022-03-08
-
2022-03-09
Survey response — days 1–6 daily, dose 3MedDRA: Feeling abnormal, Irritability — Feeling: Poor · Muscle or body aches, Fatigue or tirednessFree text: Don't feel too bad but it feels like I'm irritatedMedDRA releases: 2024-11 · check-in free text available
-
2022-03-10
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-03-11
- 2022-03-12
- 2022-03-13
- 2022-03-14
- 2022-03-15
- 2022-03-22
- 2022-03-29
- 2022-04-05
- 2022-04-12
- 2022-04-19
- 2022-06-07
- 2022-09-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna | |
| 2 | 2021-03-25 | Moderna | |
| 3 | 2022-03-08 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): I dont think the diarrhea was vaccine related I believe it was related to something I ate
Release 5 — day 21, dose 1
Symptoms: I had a feeling Ive been upset stomach and Wednesday evening through Thursday Friday clearing up on Sunday
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Question can the virus affect seizure medication or cause a seizure of breakthrough or do you have any reports on this happen
Systemic reaction (other): Swelling in the armpit of the left arm where the injection was given not too bad
Systemic reaction (other): Swelling in armpit area
Release 11 — days 1–6 daily, dose 3
Systemic reaction (other): Don't feel too bad but it feels like I'm irritated
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 | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | · | · | ✓ |
| SRO | Irritability | · | · | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release