66J-90011-81647
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 221 / VA
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Registered in v-safe
-
2021-01-06
Dose 1 — Moderna
- 2021-01-07
-
2021-01-08
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Missed a tennis shot that I normally would never miss😂MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-20
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Moderna
- 2021-02-10
- 2021-02-12
- 2021-02-13
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: After the first vaccine I had to blame the vaccine for missing some tennis shots. But now with vaccine #2 Im playing better than ever.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
-
2021-02-17
Survey response — day 7, dose 2MedDRA: Arthralgia, Pain — Feeling: Good · Joint pains, Muscle or body achesFree text: Minimal achiness and knee joint pain. Hard to know if it has anything g to do with the 2nd dose of the vaccine a week agoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
-
2021-03-24
Survey response — day 42, dose 2MedDRA: Immunisation reaction, Memory impairment — Feeling: GoodFree text: Mild short term memory retention issues x 2-3 wks. Its sporadic but seems unusual from my normal. Seems unlikely to be vaccine related but its the only unusual sx since vaccine # 2MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-12
- 2021-08-11
-
2022-02-11
Survey response — 12 months, dose 2MedDRA: Chills, Cough, Fatigue — Feeling: Good · Be unable to work or attend schoolFree text: Cough and fatigue chillsMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-10 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Missed a tennis shot that I normally would never miss😂
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): After the first vaccine I had to blame the vaccine for missing some tennis shots. But now with vaccine #2 Im playing better than ever.
Release 4 — day 7, dose 2
Systemic reaction (other): Minimal achiness and knee joint pain. Hard to know if it has anything g to do with the 2nd dose of the vaccine a week ago
Release 6 — day 42, dose 2
Symptoms: Mild short term memory retention issues x 2-3 wks. Its sporadic but seems unusual from my normal. Seems unlikely to be vaccine related but its the only unusual sx since vaccine # 2
Release 11 — 12 months, dose 2
Symptoms: Cough and fatigue chills
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 | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Memory impairment | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release