6RK-18442-14181
2 vaccinations
4 coded responses
25 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 21-25
- ZIP prefix
- 110 / NY
- Registered
- 2021-04-14
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-14
Registered in v-safe
-
2021-04-14
Dose 1 — Moderna
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-28
- 2021-05-05
-
2021-05-12
Survey response — day 28, dose 1MedDRA: Headache, Hypersensitivity, Nasopharyngitis, Pre-existing disease, Pruritus — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I went out in the rain a few days ago and since then have has worse allergy symptoms and what feels like a cold. My throat is okay but I am blowing my nose all day and it's itchier than before. I also have a headache. Temperature is 97.4.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-17
Dose 2 — Moderna
-
2021-05-19
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Pyrexia — Feeling: Good · Site: PainFree text: The form did not ask me for May 18th since I retro entered vaccine info. Yesterday I experienced a fever and headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-20
Survey response — days 1–6 daily, dose 2MedDRA: Anxiety, Restlessness — Feeling: Good · Site: PainFree text: I have experienced some anxiousness / restlessness for 2 days after the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-21
- 2021-05-22
- 2021-05-23
- 2021-05-24
- 2021-05-31
- 2021-06-07
- 2021-06-14
- 2021-06-21
- 2021-06-28
- 2021-08-16
- 2021-11-15
-
2022-05-17
Survey response — 12 months, dose 2MedDRA: Nasopharyngitis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Regular coldMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-14 | Moderna | |
| 2 | 2021-05-17 | Moderna |
Free text
Release 8 — day 28, dose 1
Symptoms: I went out in the rain a few days ago and since then have has worse allergy symptoms and what feels like a cold. My throat is okay but I am blowing my nose all day and it's itchier than before. I also have a headache. Temperature is 97.4.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): The form did not ask me for May 18th since I retro entered vaccine info. Yesterday I experienced a fever and headache.
Systemic reaction (other): I have experienced some anxiousness / restlessness for 2 days after the vaccine.
Release 11 — 12 months, dose 2
Symptoms: Regular cold
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 | Headache | ✓ | ✓ | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Restlessness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release