66G-28622-26224
2 vaccinations
6 coded responses
15 check-ins
6 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 206 / MD
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Dose 1 — Moderna
-
2021-01-15
Registered in v-safe
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2021-01-15
Survey response — days 1–6 daily, dose 1MedDRA: Urine odour abnormal — Feeling: Fair · Site: Pain · Headache, NauseaFree text: Urine has a strange smell...more so on day 1.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal pain upper, Urine odour abnormal — Feeling: Fair · Site: Pain · Fever · Headache, Nausea, Abdominal painFree text: Urine has a strange odor. Slight pain in lower part of my stomach.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
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2021-01-28
Survey response — day 14, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: The spot of injection has gotten sore over the last couple of days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
-
2021-02-11
Dose 2 — Moderna
- 2021-02-25
- 2021-03-04
-
2021-03-11
Survey response — day 28, dose 2MedDRA: Gout — Feeling: FairFree text: I have been suffering from a severe case of gout that has been going on over two weeks.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-20
Survey response — day 35, dose 2MedDRA: Feeling hot, Gout, Office visit — Feeling: Poor · Get care from a doctor or other healthcare professionalFree text: Symptoms: Arm felt as though it is runnibg a fever...goutin left foot for over 30 days and doesn't appear to be getting any better. · Healthcare visit (other): Primary care doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-20
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-25
Survey response — day 42, dose 2MedDRA: Gout — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Still dealing with gout in left foot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-25
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-14
-
2021-12-30
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-02-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-11 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Urine has a strange smell...more so on day 1.
Systemic reaction (other): Urine has a strange odor. Slight pain in lower part of my stomach.
Release 3 — day 14, dose 1
Symptoms: The spot of injection has gotten sore over the last couple of days.
Release 5 — day 28, dose 2
Symptoms: I have been suffering from a severe case of gout that has been going on over two weeks.
Release 6 — day 35, dose 2
Symptoms: Arm felt as though it is runnibg a fever...goutin left foot for over 30 days and doesn't appear to be getting any better.
Healthcare visit (other): Primary care doctor
Release 6 — day 42, dose 2
Symptoms: Still dealing with gout in left foot.
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Feeling hot | ✓ | ✓ | ✓ |
| SD | Gout | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Abdominal pain upper | ✓ | ✓ | ✓ |
| SRO | Urine odour abnormal | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release