69U-16850-67419
2 vaccinations
5 coded responses
22 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 789 / TX
- Registered
- 2021-03-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-22
Registered in v-safe
-
2021-03-22
Dose 1 — Moderna
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2021-03-22
Survey response — day 0, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Just soreness at the injection site. It feels the same as having any other injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-23
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessAdult check-in
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-04-05
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2021-04-12
Survey response — day 21, dose 1MedDRA: Aphthous ulcer, Glossodynia — Feeling: GoodFree text: It may be unrelated to the vaccine, but a canker-type sore developed under my tongue, which lasted approximately 3 days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Dose 2 — Moderna
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2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain · Chills, Fatigue or tirednessFree text: I dont know if its related to the vaccination, but three days after the shot was administered I have a sore and swollen lymph node near my left clavicle. It may be a symptom of something else.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Lymph node pain, Lymphadenopathy — Feeling: GoodFree text: The aforementioned lymph node near my left collarbone is still sore, but The swelling has gone down a bit.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-21
Survey response — days 1–6 daily, dose 2MedDRA: Lymph node pain, Lymphadenopathy — Feeling: GoodFree text: The aforementioned lymph node has continue to decrease in swelling and in soreness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-22
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-16
- 2021-05-21
- 2021-05-28
- 2021-07-18
- 2021-10-15
- 2022-04-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-22 | Moderna | |
| 2 | 2021-04-16 | Moderna |
Free text
Release 6 — day 0, dose 1
Systemic reaction (other): Just soreness at the injection site. It feels the same as having any other injection.
Release 7 — day 21, dose 1
Symptoms: It may be unrelated to the vaccine, but a canker-type sore developed under my tongue, which lasted approximately 3 days.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I dont know if its related to the vaccination, but three days after the shot was administered I have a sore and swollen lymph node near my left clavicle. It may be a symptom of something else.
Systemic reaction (other): The aforementioned lymph node near my left collarbone is still sore, but The swelling has gone down a bit.
Systemic reaction (other): The aforementioned lymph node has continue to decrease in swelling and in soreness.
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 | Aphthous ulcer | ✓ | ✓ | ✓ |
| SD | Glossodynia | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release