6TM-27498-86410
3 vaccinations
3 coded responses
33 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 117 / NY
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
-
2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal discomfort — Feeling: Good · Site: PainFree text: Very Slight tickle in throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-02-04
- 2021-02-11
- 2021-02-18
-
2021-02-22
Dose 2 — Moderna
-
2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Fatigue, Headache, Insomnia, Nausea, Pyrexia, Self-medication — Feeling: Good · Fatigue or tirednessFree text: About 8 hrs after I got the vaccine I ran a fever of 101, chills, headache, nausea. Didnt sleep that night. When I woke up ( tues, Feb 23) had the same symptoms with fatigue. I took Tylenol xtra strength which helped somewhat. Tylenol brought my fever to 100. I went to bed, slept the night and on Wednesday morning Feb 24. Felt better. No fever, just very fatigued. Today is Thursday Feb 25th and Im completely better.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-05-24
- 2021-08-23
-
2021-10-25
Dose 3 — Moderna
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Pain, Self-medication — Feeling: Good · Site: Pain, SwellingFree text: Felt body aches 8 hrs and the next day, Oct 26. Tylenol helpedMedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2022-01-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-22 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Very Slight tickle in throat
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): About 8 hrs after I got the vaccine I ran a fever of 101, chills, headache, nausea. Didnt sleep that night. When I woke up ( tues, Feb 23) had the same symptoms with fatigue. I took Tylenol xtra strength which helped somewhat. Tylenol brought my fever to 100. I went to bed, slept the night and on Wednesday morning Feb 24. Felt better. No fever, just very fatigued. Today is Thursday Feb 25th and Im completely better.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Felt body aches 8 hrs and the next day, Oct 26. Tylenol helped
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 | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal discomfort | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release