68J-14492-28792
5 vaccinations
10 coded responses
69 check-ins
9 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 871 / NM
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Registered in v-safe
-
2021-03-31
Dose 1 — Moderna
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2021-03-31
Health check-in — day 0, dose 1Feeling: Good · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-01
-
2021-04-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-14
- 2021-04-21
-
2021-04-28
Dose 2 — Moderna
- 2021-04-28
-
2021-04-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-30
-
2021-05-01
Survey response — days 1–6 daily, dose 2MedDRA: Blood pressure increased — Feeling: GoodFree text: My blood pressure has been elevated since my shot: 130s/80s vs 120s/70s before.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-05-03
-
2021-05-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Headache, Fatigue or tirednessAdult check-in
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-27
- 2021-06-02
- 2021-06-09
- 2021-07-28
-
2021-10-27
Survey response — 6 months, dose 2MedDRA: Skin papilloma — Feeling: GoodFree text: Warts on my right handMedDRA releases: 2024-11 · check-in free text available
-
2021-11-03
Dose 3 — Moderna
- 2021-11-03
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-11-05
Survey response — days 1–6 daily, dose 3MedDRA: Thirst — Feeling: Good · Site: PainFree text: Been thirsty since I got my shot. It's gotten better since then, but I'm thirstier than before the booster.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Nasal congestion — Feeling: Good · Site: PainFree text: Slight stuffy nose (started yesterday) and slight cough (this morning)MedDRA releases: 2024-11 · check-in free text available
-
2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Contusion, Thirst — Feeling: Good · ChillsFree text: Still thirsty a lot, but better. Also have a bruise on my leg.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-08
- 2021-11-09
- 2021-11-10
- 2021-11-17
- 2021-11-25
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2022-02-02
-
2022-05-02
Dose 4 — Moderna
- 2022-05-02
- 2022-05-03
-
2022-05-04
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-05-05
Survey response — days 1–6 daily, dose 4MedDRA: Aphthous ulcer — Feeling: GoodFree text: Canker sore on the inside of my cheekMedDRA releases: 2024-11 · check-in free text available
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2022-05-06
Survey response — days 1–6 daily, dose 4MedDRA: Aphthous ulcer — Feeling: GoodFree text: Canker sore on the inside of my right cheekMedDRA releases: 2024-11 · check-in free text available
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2022-05-07
Survey response — days 1–6 daily, dose 4MedDRA: Aphthous ulcer — Feeling: GoodFree text: Canker sore on the inside of my right cheek seems to be getting better.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-08
- 2022-05-11
- 2022-05-16
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2022-05-23
Survey response — day 21, dose 4MedDRA: Diarrhoea — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Had diarrhea for about 18 hours from early Thursday morning through Thursday evening.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-01
- 2022-06-06
- 2022-06-15
- 2022-08-01
- 2022-10-31
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2022-11-03
Dose 5 — Moderna
- 2022-11-03
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2022-11-04
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-11-05
- 2022-11-06
- 2022-11-07
- 2022-11-08
- 2022-11-09
- 2022-11-11
- 2022-11-17
- 2022-11-24
- 2022-12-01
- 2022-12-08
- 2022-12-16
- 2023-02-02
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2023-05-04
Survey response — 6 months, dose 5MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitMedDRA releases: 2024-11
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2023-05-04
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
- 2023-05-05
-
2023-05-05
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-28 | Moderna | |
| 3 | 2021-11-03 | Moderna | No |
| 4 | 2022-05-02 | Moderna | No |
| 5 | 2022-11-03 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): My blood pressure has been elevated since my shot: 130s/80s vs 120s/70s before.
Release 10 — 6 months, dose 2
Symptoms: Warts on my right hand
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Been thirsty since I got my shot. It's gotten better since then, but I'm thirstier than before the booster.
Systemic reaction (other): Slight stuffy nose (started yesterday) and slight cough (this morning)
Systemic reaction (other): Still thirsty a lot, but better. Also have a bruise on my leg.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Canker sore on the inside of my cheek
Systemic reaction (other): Canker sore on the inside of my right cheek
Systemic reaction (other): Canker sore on the inside of my right cheek seems to be getting better.
Release 11 — day 21, dose 4
Symptoms: Had diarrhea for about 18 hours from early Thursday morning through Thursday evening.
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 | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Skin papilloma | · | · | ✓ |
| SRO | Aphthous ulcer | · | · | ✓ |
| SRO | Blood pressure increased | ✓ | ✓ | ✓ |
| SRO | Contusion | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Thirst | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release