65N-20309-35566
2 vaccinations
2 coded responses
16 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 857 / AZ
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-25
Dose 1 — Moderna
-
2021-03-05
Registered in v-safe
-
2021-03-05
Health check-in — day 7, dose 1Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-11
- 2021-03-18
-
2021-03-25
Dose 2 — Moderna
-
2021-03-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
-
2021-03-29
Survey response — days 1–6 daily, dose 2MedDRA: Arthritis, Pain in extremity — Feeling: Fair · Site: Redness, Itching · Fever · Joint pains, Fatigue or tirednessFree text: I have off writers in my hands after I got the shot my right hand the finger by the some I could hardly cold anything it hurts so much it's a lot better nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Joint pains, Fatigue or tirednessAdult check-in
-
2021-03-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Joint pains, Fatigue or tirednessAdult check-in
-
2021-04-01
Health check-in — day 7, dose 2Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-06-24
- 2021-09-23
-
2022-03-25
Survey response — 12 months, dose 2MedDRA: Dyspnoea, Fall, Musculoskeletal chest pain, Office visit, Rash, Rib fracture, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I have rat rash on both my legs down towards my ankles I had problems going to the bathroom but it seems like it's clearing up I saw the doctor I had fallen and practured my thrill practiced my 3 or 4 ribs which are healing I was having problems brea · Healthcare visit (other): I saw a doctor for my ribs I tried to talk to my doctor she said she get back to me and she never did that's why I went in instead of seeing her I ended up seeing her supervisor I don't know what this is right between my ribs at the top I tried to exMedDRA releases: 2024-11 · check-in free text available
-
2022-03-25
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2022-03-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna | |
| 2 | 2021-03-25 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): I have off writers in my hands after I got the shot my right hand the finger by the some I could hardly cold anything it hurts so much it's a lot better now
Release 11 — 12 months, dose 2
Symptoms: I have rat rash on both my legs down towards my ankles I had problems going to the bathroom but it seems like it's clearing up I saw the doctor I had fallen and practured my thrill practiced my 3 or 4 ribs which are healing I was having problems brea cut off by CDC
Healthcare visit (other): I saw a doctor for my ribs I tried to talk to my doctor she said she get back to me and she never did that's why I went in instead of seeing her I ended up seeing her supervisor I don't know what this is right between my ribs at the top I tried to ex cut off by CDC
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 |
|---|---|---|---|---|
| HCVO | Musculoskeletal chest pain | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rib fracture | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Arthritis | ✓ | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release