6Q3-85648-80506
4 vaccinations
8 coded responses
52 check-ins
8 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 925 / CA
- Registered
- 2021-02-10
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-10
Registered in v-safe
-
2021-02-10
Dose 1 — Moderna
- 2021-02-10
-
2021-02-11
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Fatigue or tirednessFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-12
-
2021-02-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness · Fatigue or tirednessAdult check-in
- 2021-02-14
- 2021-02-15
-
2021-02-16
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
-
2021-03-11
Dose 2 — Moderna
-
2021-03-11
Health check-in — day 0, dose 2Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
-
2021-03-12
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: Good · Fatigue or tirednessFree text: Some Shoulder pain- I do have symptoms from preexisting condition I had prior to pandemic but focusing on vaccine symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Survey response — days 1–6 daily, dose 2MedDRA: Vaccination site pain — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Pain/soreness in vaccine shoulder.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Injection site joint pain, Neck pain, Pain in extremity — Feeling: GoodFree text: There is still some soreness in injection shoulder. Right now I feel pretty good but yesterday about 1hour after safe check up some pain in shoulder resonated in arm and neck and had slight headache. That could vaccination and/or preexisting condition.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: GoodFree text: Shoulder still a little soreMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: GoodFree text: Shoulder still a little sore... thats about itMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-17
- 2021-03-18
- 2021-03-25
- 2021-04-01
-
2021-04-08
Survey response — day 28, dose 2MedDRA: Eye pruritus, Pruritus — Feeling: GoodFree text: Slight itching sorta comes and goes around left side face, ear and around eyes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
- 2021-04-22
- 2021-06-10
- 2021-09-09
-
2021-10-27
Dose 3 — Moderna
- 2021-10-27
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Joint pains, Muscle or body achesAdult check-in
- 2021-10-30
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Good · Joint pains, Muscle or body achesAdult check-in
-
2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-11-02
- 2021-11-03
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2022-01-26
-
2022-04-11
Dose 4 — Moderna
- 2022-04-15
- 2022-04-16
-
2022-04-17
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: Good · Site: Pain · Joint painsFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2022-04-18
- 2022-04-25
- 2022-05-04
- 2022-05-09
- 2022-05-16
- 2022-05-23
- 2022-07-11
- 2022-10-10
- 2023-04-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | |
| 2 | 2021-03-11 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-11 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): No
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Some Shoulder pain- I do have symptoms from preexisting condition I had prior to pandemic but focusing on vaccine symptoms
Systemic reaction (other): Pain/soreness in vaccine shoulder.
Systemic reaction (other): There is still some soreness in injection shoulder. Right now I feel pretty good but yesterday about 1hour after safe check up some pain in shoulder resonated in arm and neck and had slight headache. That could vaccination and/or preexisting condition.
Systemic reaction (other): Shoulder still a little sore
Systemic reaction (other): Shoulder still a little sore... thats about it
Release 7 — day 28, dose 2
Symptoms: Slight itching sorta comes and goes around left side face, ear and around eyes.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): No
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 | Eye pruritus | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site joint pain | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Vaccination site pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release