687-14607-40603
4 vaccinations
7 coded responses
29 check-ins
7 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 117 / NY
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-13
Registered in v-safe
-
2021-04-13
Dose 1 — Moderna
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-18
- 2021-04-19
- 2021-04-20
-
2021-04-27
Survey response — day 14, dose 1MedDRA: Oropharyngeal pain — Feeling: GoodFree text: mild sore throat 3 days nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-04
-
2021-05-11
Dose 2 — Moderna
-
2021-05-12
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-05-13
Survey response — days 1–6 daily, dose 2MedDRA: Brain fog — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Abdominal painFree text: slight brain fogMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-14
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Good · Site: Pain, Redness, Itching · Headache, Abdominal painFree text: slightly lightheadedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-15
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-06-08
- 2021-06-15
-
2021-06-23
Survey response — day 42, dose 2MedDRA: Headache — Feeling: GoodFree text: 4 day headache. 6/14 to 6/18.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-10
Survey response — 3 months, dose 2MedDRA: Head discomfort, Headache — Feeling: Good · Be unable to do your normal daily activitiesFree text: pressure headache. approx 2 weeks, 7,15,21 to 7,29,21, HBP feeling in head.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-11-11
-
2021-12-03
Dose 3 — Moderna
- 2021-12-21
- 2021-12-24
- 2021-12-31
- 2022-01-11
-
2022-07-18
Dose 4 — Moderna
-
2022-07-22
Survey response — days 1–6 daily, dose 4MedDRA: Arthralgia, Chills, Pyrexia — Feeling: Good · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: joint aches, chills, & fever for 1 day following 2nd boosterMedDRA releases: 2024-11 · check-in free text available
- 2022-07-23
- 2022-07-26
-
2022-08-05
Survey response — day 14, dose 4MedDRA: Erythema, Flushing, Pruritus — Feeling: GoodFree text: redness and itching all over body, flush red neck, chest ankles, excessive scratching ... comes and goes, 1 week now. itching shows up at different locations daily, then dissappearsMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-13 | Moderna | |
| 2 | 2021-05-11 | Moderna | |
| 3 | 2021-12-03 | Moderna | No |
| 4 | 2022-07-18 | Moderna | No |
Free text
Release 8 — day 14, dose 1
Symptoms: mild sore throat 3 days now
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): slight brain fog
Systemic reaction (other): slightly lightheaded
Release 9 — day 42, dose 2
Symptoms: 4 day headache. 6/14 to 6/18.
Release 9 — 3 months, dose 2
Symptoms: pressure headache. approx 2 weeks, 7,15,21 to 7,29,21, HBP feeling in head.
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): joint aches, chills, & fever for 1 day following 2nd booster
Release 12 — day 14, dose 4
Symptoms: redness and itching all over body, flush red neck, chest ankles, excessive scratching ... comes and goes, 1 week now. itching shows up at different locations daily, then dissappears
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 | Erythema | · | · | ✓ |
| SD | Flushing | · | · | ✓ |
| SD | Head discomfort | ✓ | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pruritus | · | · | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Brain fog | ✓ | ✓ | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release