6WA-17770-89640
5 vaccinations
17 coded responses
67 check-ins
16 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 786 / TX
- Registered
- 2021-03-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-06
Registered in v-safe
-
2021-03-06
Dose 1 — Moderna
-
2021-03-06
Survey response — day 0, dose 1MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
-
2021-03-20
Survey response — day 14, dose 1MedDRA: Pain in extremity — Feeling: GoodFree text: This is probably nothing. The arm I got the shot in has gotten more sore. Entirely possible it has nothing to do with the vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-27
-
2021-04-01
Dose 2 — Moderna
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-07-01
- 2021-09-30
-
2021-11-12
Dose 3 — Moderna
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2021-11-12
Survey response — day 0, dose 3MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2021-11-13
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: PainFree text: NoMedDRA releases: 2024-11 · check-in free text available
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2021-11-14
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: PainFree text: NoMedDRA releases: 2024-11 · check-in free text available
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2021-11-15
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
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2021-11-16
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
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2021-11-17
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pruritus — Feeling: GoodFree text: A little itchiness at injection site last night. Nothing nowMedDRA releases: 2024-11 · check-in free text available
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2021-11-18
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2024-11 · check-in free text available
-
2021-11-19
Survey response — day 7, dose 3MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2021-12-17
- 2021-12-24
- 2022-02-11
- 2022-05-13
-
2022-05-26
Dose 4 — Moderna
- 2022-05-26
- 2022-05-27
-
2022-05-28
Survey response — days 1–6 daily, dose 4MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Injection site pain almost goneMedDRA releases: 2024-11 · check-in free text available
- 2022-05-30
- 2022-06-01
- 2022-06-02
- 2022-06-09
- 2022-06-16
- 2022-06-23
- 2022-06-30
- 2022-07-07
- 2022-08-25
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2022-10-05
Dose 5 — ModernaCo-administered: Flu
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2022-10-05
Survey response — day 0, dose 5MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
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2022-10-06
Survey response — days 1–6 daily, dose 5MedDRA: No adverse event — Feeling: Good · Site: PainFree text: NoMedDRA releases: 2024-11 · check-in free text available
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2022-10-07
Survey response — days 1–6 daily, dose 5MedDRA: Injection site pruritus, Pain — Feeling: Good · Site: PainFree text: Injection site was itchy yesterday evening but not today. Soreness much less todayMedDRA releases: 2024-11 · check-in free text available
- 2022-10-08
- 2022-10-09
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2022-10-10
Survey response — days 1–6 daily, dose 5MedDRA: Headache — Feeling: Good · HeadacheFree text: Think headache is heat related.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-11
- 2022-10-12
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2022-10-19
Survey response — day 14, dose 5MedDRA: Cough, Pre-existing disease, Respiratory tract congestion — Feeling: FairFree text: Probably elm pollen allergy but congested with cough.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-26
- 2022-11-02
- 2022-11-09
- 2022-11-16
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2023-01-04
Survey response — 3 months, dose 5MedDRA: Respiratory tract congestion — Feeling: GoodMedDRA releases: 2024-11
- 2023-04-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-06 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
| 4 | 2022-05-26 | Moderna | No |
| 5 | 2022-10-05 | Moderna | Flu |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): No
Release 6 — day 14, dose 1
Symptoms: This is probably nothing. The arm I got the shot in has gotten more sore. Entirely possible it has nothing to do with the vaccination.
Release 10 — day 0, dose 3
Systemic reaction (other): No
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): No
Systemic reaction (other): No
Systemic reaction (other): No
Systemic reaction (other): No
Systemic reaction (other): A little itchiness at injection site last night. Nothing now
Systemic reaction (other): None
Release 10 — day 7, dose 3
Systemic reaction (other): No
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Injection site pain almost gone
Release 12 — day 0, dose 5
Systemic reaction (other): No
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): No
Systemic reaction (other): Injection site was itchy yesterday evening but not today. Soreness much less today
Systemic reaction (other): Think headache is heat related.
Release 12 — day 14, dose 5
Symptoms: Probably elm pollen allergy but congested with cough.
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 | Cough | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Injection site pruritus | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release