695-53250-77538
3 vaccinations
4 coded responses
20 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 547 / WI
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-01-21
Dose 1 — Moderna
-
2021-01-22
Registered in v-safe
- 2021-01-22
-
2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: The pain level is very slight, maximum of 2 on a 1-10scale. Not interfering with daily activities. I would prefer nobody put pressure on the site but if it happened it would not be a big issue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
-
2021-02-04
Survey response — day 14, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Curious, since my last check-in I have had a slight soreness in my injection arm, 1-2 of 10 soreness that is there daily. Not at the shot site but about 4-5 inches lower. It is not causing a restriction of any activity.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
-
2021-02-18
Dose 2 — Moderna
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-02
- 2021-05-20
-
2021-08-19
Survey response — 6 months, dose 2MedDRA: Inflammation — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Two bouts of severe, debilitating, inflammation lasting about 2 days each. No previous occurrences. Did not associate the inflammation with vaccination at the time of the inflammation. Not making a positive association now but it is coincidental.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-03
Dose 3 — Moderna
-
2021-12-05
Survey response — 3 months, dose 3MedDRA: Injection site pain, Paraesthesia — Feeling: GoodFree text: Tingling in my left shoulder and left upper arm. Occasional soreness at my shot site.MedDRA releases: 2024-11 · check-in free text available
- 2022-03-04
- 2022-09-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-18 | Moderna | |
| 3 | 2021-09-03 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): The pain level is very slight, maximum of 2 on a 1-10scale. Not interfering with daily activities. I would prefer nobody put pressure on the site but if it happened it would not be a big issue.
Release 3 — day 14, dose 1
Symptoms: Curious, since my last check-in I have had a slight soreness in my injection arm, 1-2 of 10 soreness that is there daily. Not at the shot site but about 4-5 inches lower. It is not causing a restriction of any activity.
Release 9 — 6 months, dose 2
Symptoms: Two bouts of severe, debilitating, inflammation lasting about 2 days each. No previous occurrences. Did not associate the inflammation with vaccination at the time of the inflammation. Not making a positive association now but it is coincidental.
Release 10 — 3 months, dose 3
Symptoms: Tingling in my left shoulder and left upper arm. Occasional soreness at my shot site.
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 | Inflammation | ✓ | · | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release