66X-16796-98164
4 vaccinations
3 coded responses
31 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 783 / TX
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-01
Registered in v-safe
-
2021-04-01
Dose 1 — Moderna
- 2021-04-01
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-07
- 2021-04-08
- 2021-04-16
-
2021-04-22
Survey response — day 21, dose 1MedDRA: Dyspnoea, Headache, Pain — Feeling: GoodFree text: Headache, short breaths, hurt all over so bad just wanted to cash it in. Lasted 2 or 3 days then it went away. Feel just fine now. My friend that got shot same day I did is ill now, few days after I was. Should be ok by now. Have heard nothing newMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-29
Dose 2 — Moderna
- 2021-04-29
-
2021-04-30
Survey response — days 1–6 daily, dose 2MedDRA: Influenza like illness, Injection site pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Like having the flu, seems to be moderating now, feel as though it should subside by tomorrow. Pain at shot site feeling much betterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
- 2021-05-02
- 2021-05-03
-
2021-05-04
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pruritus, Pruritus — Feeling: Good · Site: ItchingFree text: It had always itched, just failed to mention it. The has started from the shot and has moved down my arm. Near my elbow at this timeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-05
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-29
- 2021-06-03
- 2021-06-10
- 2021-07-29
- 2021-10-30
-
2021-11-15
Dose 3 — Moderna
-
2022-04-16
Dose 4 — Moderna
- 2022-05-01
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-05-28
- 2022-07-16
- 2022-10-15
- 2023-04-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-04-29 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-04-16 | Moderna | No |
Free text
Release 7 — day 21, dose 1
Symptoms: Headache, short breaths, hurt all over so bad just wanted to cash it in. Lasted 2 or 3 days then it went away. Feel just fine now. My friend that got shot same day I did is ill now, few days after I was. Should be ok by now. Have heard nothing new
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Like having the flu, seems to be moderating now, feel as though it should subside by tomorrow. Pain at shot site feeling much better
Systemic reaction (other): It had always itched, just failed to mention it. The has started from the shot and has moved down my arm. Near my elbow at this time
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 | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SRO | Influenza like illness | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release