5XZ-13622-02073
2 vaccinations
2 coded responses
23 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 972 / OR
- Registered
- 2021-03-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-05
Dose 1 — Moderna
-
2021-03-08
Registered in v-safe
-
2021-03-08
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-19
- 2021-03-26
-
2021-04-02
Dose 2 — Moderna
- 2021-04-02
- 2021-04-03
-
2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-04-06
- 2021-04-07
-
2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Blood glucose increased, Pre-existing disease — Feeling: GoodFree text: I am diabetic, and my blood sugar levels seem to have gone up significantly since getting the injection. I didn't notice this after the first dose, but it happened during/after a febrile illness last November (which was COVID negative and was most likely the flu).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-07-02
- 2021-10-01
-
2022-04-02
Survey response — 12 months, dose 2MedDRA: Influenza like illness, SARS-CoV-2 test negative — Feeling: GoodFree text: Mild flu-like illness two weeks ago lasting 5-6 days. I suspect it was the flu, though I'd had a flu shot. At-home COVID tests negative x2 during illness.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I am diabetic, and my blood sugar levels seem to have gone up significantly since getting the injection. I didn't notice this after the first dose, but it happened during/after a febrile illness last November (which was COVID negative and was most likely the flu).
Release 11 — 12 months, dose 2
Symptoms: Mild flu-like illness two weeks ago lasting 5-6 days. I suspect it was the flu, though I'd had a flu shot. At-home COVID tests negative x2 during illness.
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 | Influenza like illness | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Blood glucose increased | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release