64U-17501-26659
4 vaccinations
8 coded responses
37 check-ins
8 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 760 / TX
- Registered
- 2021-03-22
- Relationship
- Self
- Race
- Other
- Ethnicity
- N/A
Timeline
-
2021-03-22
Registered in v-safe
-
2021-03-22
Dose 1 — Moderna
- 2021-03-22
- 2021-03-23
-
2021-03-24
Survey response — days 1–6 daily, dose 1MedDRA: Night sweats, Poor quality sleep — Feeling: GoodFree text: Some light night sweats. Sleep a little restlessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
- 2021-03-26
- 2021-03-29
- 2021-04-05
- 2021-04-12
- 2021-04-19
-
2021-04-20
Dose 2 — Moderna
- 2021-04-26
-
2021-04-27
Survey response — day 7, dose 2MedDRA: Chills, Fatigue, Headache — Feeling: GoodFree text: Day Two after 2nd shot felt 80%; mild headache & fatigue. moderate chills by evening. Went to bed early and woke up feeling 100%MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-07-20
- 2021-10-20
-
2021-10-26
Dose 3 — ModernaCo-administered: Pneumonia
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2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Chills, Hyperhidrosis — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sweats alternating chillsMedDRA releases: 2024-11 · check-in free text available
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2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Cold sweat — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Cold sweats sleepingMedDRA releases: 2024-11 · check-in free text available
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2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Abdominal distension, Abdominal pain upper, Dehydration, Fatigue, Laboratory test abnormal, Lactose intolerance, Pyrexia — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sore stomach. This started as fatigue and fever Thursday two days after my shot. I think I let myself get dehydrated which gave me yes Titus. This destroyed my. Lactose enzymes and I bloated and had lactose intolerance. I'm 65 and never had it beforMedDRA releases: 2024-11 · check-in free text available
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2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Hyperhidrosis, Night sweats — Feeling: Fair · Headache · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sweats, mostly at nightMedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Survey response — day 7, dose 3MedDRA: Night sweats — Feeling: Good · Muscle or body achesFree text: Late night sweatMedDRA releases: 2024-11 · check-in free text available
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2022-01-25
- 2022-04-26
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2022-04-27
Dose 4 — Moderna
- 2022-05-18
- 2022-05-25
- 2022-06-01
- 2022-06-08
- 2022-07-27
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2022-10-28
Survey response — 6 months, dose 4MedDRA: COVID-19, Fatigue, Headache, Nasopharyngitis, Nausea, Pulmonary congestion, SARS-CoV-2 test — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Positive with Covid. Suspect contracted at a wedding on October 15 felt fatigued on the 17th felt like a bad cold on the 18th including headache and nausea took a Covid test. Recovering now with some lung congestionMedDRA releases: 2024-11 · check-in free text available
- 2023-04-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-22 | Moderna | |
| 2 | 2021-04-20 | Moderna | |
| 3 | 2021-10-26 | Moderna | Pneumonia |
| 4 | 2022-04-27 | Moderna | No |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Some light night sweats. Sleep a little restless
Release 8 — day 7, dose 2
Systemic reaction (other): Day Two after 2nd shot felt 80%; mild headache & fatigue. moderate chills by evening. Went to bed early and woke up feeling 100%
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sweats alternating chills
Systemic reaction (other): Cold sweats sleeping
Systemic reaction (other): Sore stomach. This started as fatigue and fever Thursday two days after my shot. I think I let myself get dehydrated which gave me yes Titus. This destroyed my. Lactose enzymes and I bloated and had lactose intolerance. I'm 65 and never had it befor cut off by CDC
Systemic reaction (other): Sweats, mostly at night
Release 10 — day 7, dose 3
Systemic reaction (other): Late night sweat
Release 12 — 6 months, dose 4
Symptoms: Positive with Covid. Suspect contracted at a wedding on October 15 felt fatigued on the 17th felt like a bad cold on the 18th including headache and nausea took a Covid test. Recovering now with some lung congestion
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 | COVID-19 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pulmonary congestion | · | · | ✓ |
| SD | SARS-CoV-2 test | · | · | ✓ |
| SRO | Abdominal distension | · | · | ✓ |
| SRO | Abdominal pain upper | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Cold sweat | · | · | ✓ |
| SRO | Dehydration | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | · | · | ✓ |
| SRO | Laboratory test abnormal | · | · | ✓ |
| SRO | Lactose intolerance | · | · | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | Poor quality sleep | ✓ | ✓ | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release