6RD-94457-23093
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 921 / CA
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
-
2021-01-15
Survey response — day 0, dose 1MedDRA: Anxiety — Feeling: Good · Site: PainFree text: AnxietyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-16
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-17
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Injection site erythema, Injection site swelling — Feeling: Good · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tirednessFree text: I had mild redness and mild swelling at injection site on 1/17/21 and 1/16/21 but could not edit my response after it was submittedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-19
Survey response — days 1–6 daily, dose 1MedDRA: SARS-CoV-2 test positive — Feeling: Good · Site: Pain, SwellingFree text: Dont remember if initial questions covered this but I tested positive for COVID August 2020 (antigen test) and was asymptomaticMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-22
- 2021-01-29
- 2021-02-05
-
2021-02-12
Dose 2 — Moderna
-
2021-02-12
Survey response — day 0, dose 2MedDRA: Asymptomatic COVID-19, SARS-CoV-2 test positive — Feeling: GoodFree text: I tested positive (antigen test) for COVID in August 2020. I had no symptoms of COVID at that time, not two weeks before or after.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: LightheadednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-05-14
- 2021-08-13
- 2022-02-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
2 call center cases
2 priority 2/3 (triaged and no follow up)
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): Anxiety
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): I had mild redness and mild swelling at injection site on 1/17/21 and 1/16/21 but could not edit my response after it was submitted
Systemic reaction (other): Dont remember if initial questions covered this but I tested positive for COVID August 2020 (antigen test) and was asymptomatic
Release 4 — day 0, dose 2
Systemic reaction (other): I tested positive (antigen test) for COVID in August 2020. I had no symptoms of COVID at that time, not two weeks before or after.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Lightheadedness
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 |
|---|---|---|---|---|
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Asymptomatic COVID-19 | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release