675-17129-58678
4 vaccinations
7 coded responses
42 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 302 / GA
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Dose 1 — Moderna
-
2021-01-25
Registered in v-safe
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-02-06
- 2021-02-14
-
2021-02-20
Dose 2 — Moderna
- 2021-02-20
-
2021-02-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Swelling · Chills, Headache, Fatigue or tirednessAdult check-in
-
2021-02-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness · Headache, Fatigue or tirednessAdult check-in
- 2021-02-23
-
2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus — Feeling: Good · HeadacheFree text: Sporadic itchy areas on legs top of feet top of hands and armsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
-
2021-02-27
Survey response — day 7, dose 2MedDRA: Pruritus — Feeling: Good · Site: ItchingFree text: Random spots of itching for short peroids of time on ams/hands and ankles/feet.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
-
2021-03-13
Survey response — day 21, dose 2MedDRA: Pruritus — Feeling: GoodFree text: The spotty itching on feet,ankles, top of feet, and ankles. It is sporadic and moves randomly. No rash. Never had this before my 2 moderne jabs. More frustrating than anything. Anything that will eliminate it?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-20
Survey response — day 28, dose 2MedDRA: Ear pain, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Ear ache in left ear. Not vaccine related. · Healthcare visit (other): My family doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-20
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-27
- 2021-04-03
- 2021-05-22
- 2021-08-21
-
2021-10-26
Dose 3 — Moderna
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: Pain, Redness, Swelling · Fever · Headache, Fatigue or tirednessFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tirednessFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-10-30
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-11-02
- 2021-11-09
-
2021-11-16
Survey response — day 21, dose 3MedDRA: Fatigue, Hypersomnia — Feeling: Good · Be unable to do your normal daily activitiesFree text: I am fatigued all of the time and sleep more than 12 to 25 hours daily.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-23
- 2021-11-30
- 2021-12-08
-
2021-12-29
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-25
-
2022-03-24
Dose 4 — Moderna
- 2022-04-18
- 2022-04-21
- 2022-04-28
- 2022-05-05
- 2022-06-23
- 2022-09-22
- 2023-03-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-03-24 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Sporadic itchy areas on legs top of feet top of hands and arms
Release 4 — day 7, dose 2
Systemic reaction (other): Random spots of itching for short peroids of time on ams/hands and ankles/feet.
Release 5 — day 21, dose 2
Symptoms: The spotty itching on feet,ankles, top of feet, and ankles. It is sporadic and moves randomly. No rash. Never had this before my 2 moderne jabs. More frustrating than anything. Anything that will eliminate it?
Release 6 — day 28, dose 2
Symptoms: Ear ache in left ear. Not vaccine related.
Healthcare visit (other): My family doctor
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): No
Systemic reaction (other): No
Release 10 — day 21, dose 3
Symptoms: I am fatigued all of the time and sleep more than 12 to 25 hours daily.
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 | Ear pain | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Hypersomnia | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release