64U-11226-90225
3 vaccinations
3 coded responses
43 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 26-30
- ZIP prefix
- 537 / WI
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-08
Registered in v-safe
-
2021-04-08
Dose 1 — Janssen/Johnson & Johnson
- 2021-04-08
-
2021-04-09
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-07-08
- 2021-10-07
-
2021-10-30
Dose 2 — Moderna
- 2021-10-30
- 2021-10-31
-
2021-11-01
Survey response — days 1–6 daily, dose 2MedDRA: Epistaxis, Pre-existing disease — Feeling: GoodFree text: I had a nosebleed last night, but that has happened to me occasionally for years; this instance is likely unrelated to this vaccination.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-06
- 2021-11-13
-
2021-11-22
Survey response — day 21, dose 2MedDRA: Arthralgia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Bad pain in the shoulder where I received the shot starting Nov 13th AM, gradually resolving on the 15th and 16th. I was sleeping on a different bed than usual the nights of the 11th and 12th, though, so that could also potentially be the cause.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-27
- 2021-12-04
- 2021-12-13
- 2022-01-29
- 2022-04-30
-
2022-09-08
Dose 3 — ModernaCo-administered: Flu
- 2022-09-08
- 2022-09-09
- 2022-09-10
- 2022-09-11
- 2022-09-12
- 2022-09-17
- 2022-09-22
- 2022-09-29
- 2022-10-06
- 2022-10-13
- 2022-10-20
-
2022-12-08
Survey response — 3 months, dose 3MedDRA: Cough, Pyrexia, Respiratory symptom, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: GoodFree text: Seasonal respiratory symptoms for ~1 week in mid November: dry cough/congestion/low fever, but repeated negative COVID antigen testsMedDRA releases: 2024-11 · check-in free text available
- 2023-03-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-08 | Janssen/Johnson & Johnson | |
| 2 | 2021-10-30 | Moderna | No |
| 3 | 2022-09-08 | Moderna | Flu |
Free text
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): I had a nosebleed last night, but that has happened to me occasionally for years; this instance is likely unrelated to this vaccination.
Release 10 — day 21, dose 2
Symptoms: Bad pain in the shoulder where I received the shot starting Nov 13th AM, gradually resolving on the 15th and 16th. I was sleeping on a different bed than usual the nights of the 11th and 12th, though, so that could also potentially be the cause.
Release 12 — 3 months, dose 3
Symptoms: Seasonal respiratory symptoms for ~1 week in mid November: dry cough/congestion/low fever, but repeated negative COVID antigen tests
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 | Arthralgia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory symptom | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Epistaxis | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release