644-30635-54555
2 vaccinations
4 coded responses
25 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 920 / CA
- Registered
- 2021-01-24
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-24
Registered in v-safe
-
2021-01-24
Dose 1 — Moderna
-
2021-01-24
Survey response — day 0, dose 1MedDRA: Fatigue, Somnolence — Feeling: Fair · Site: PainFree text: tired and sleepy, like not from vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-25
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-07
-
2021-02-14
Survey response — day 21, dose 1MedDRA: Eye irritation — Feeling: GoodFree text: my eyes, in the past days, have a very very light irritation, on and off. I think it probably has nothing to do with the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-21
-
2021-02-23
Dose 2 — Moderna
-
2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: very tiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-25
- 2021-03-30
- 2021-04-06
- 2021-05-25
- 2021-08-24
-
2022-02-23
Survey response — 12 months, dose 2MedDRA: Diarrhoea, Eye pruritus, Lacrimation increased, Rhinorrhoea — Feeling: GoodFree text: after eating out in restaurent without covid protection in Jan 4, 2022, a few days later, had 1. itch eyes, waterly eyes fir 10 days, 2. running nose for 19 day, then 3. diarrheal for one day 20 day later. now, recovered.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-24 | Moderna | |
| 2 | 2021-02-23 | Moderna |
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): tired and sleepy, like not from vaccine
Release 4 — day 21, dose 1
Symptoms: my eyes, in the past days, have a very very light irritation, on and off. I think it probably has nothing to do with the vaccine.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): very tired
Release 11 — 12 months, dose 2
Symptoms: after eating out in restaurent without covid protection in Jan 4, 2022, a few days later, had 1. itch eyes, waterly eyes fir 10 days, 2. running nose for 19 day, then 3. diarrheal for one day 20 day later. now, recovered.
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 | Diarrhoea | · | · | ✓ |
| SD | Eye irritation | ✓ | ✓ | ✓ |
| SD | Eye pruritus | · | · | ✓ |
| SD | Lacrimation increased | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release