676-19653-39625
4 vaccinations
3 coded responses
40 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 105 / NY
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
-
2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Injection site reaction, Pain — Feeling: GoodFree text: Near the injection site, I have over the last few days had a strange sensation. When I raise my right arm above my head, it feels like an adhesion is pulling under the skin.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-27
Survey response — days 1–6 daily, dose 1MedDRA: Injection site reaction — Feeling: GoodFree text: Still, I feel a tightness near the injection sight that feels like adhesions just under the surface. This sensation only occurs as I stretchy my right arm above my head.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-28
Survey response — day 7, dose 1MedDRA: Skin discomfort — Feeling: GoodFree text: As mentioned over the past several days, there is still an uncomfortable feelinglike an adhesion pulling under the skin near the injection sight when I stretch my left arm above my head.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
- 2021-02-11
- 2021-02-18
-
2021-02-21
Dose 2 — Moderna
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-07
- 2021-03-14
- 2021-03-21
- 2021-03-28
- 2021-04-04
- 2021-05-23
-
2021-08-19
Dose 3 — Moderna
- 2021-08-23
- 2021-08-23
- 2021-08-24
- 2021-08-25
- 2021-08-26
- 2021-09-04
- 2021-09-09
- 2021-09-16
- 2021-09-23
- 2021-09-30
- 2021-11-18
- 2022-02-17
-
2022-04-06
Dose 4 — Moderna
- 2022-04-14
- 2022-04-20
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-10-06
- 2023-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-21 | Moderna | |
| 3 | 2021-08-19 | Moderna | No |
| 4 | 2022-04-06 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Near the injection site, I have over the last few days had a strange sensation. When I raise my right arm above my head, it feels like an adhesion is pulling under the skin.
Systemic reaction (other): Still, I feel a tightness near the injection sight that feels like adhesions just under the surface. This sensation only occurs as I stretchy my right arm above my head.
Release 3 — day 7, dose 1
Systemic reaction (other): As mentioned over the past several days, there is still an uncomfortable feelinglike an adhesion pulling under the skin near the injection sight when I stretch my left arm above my head.
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 |
|---|---|---|---|---|
| SRO | Injection site reaction | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Skin discomfort | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release