Y4Z-29654-13545
6 vaccinations
7 coded responses
66 check-ins
7 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 906 / CA
- Registered
- 2021-03-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-27
Dose 1 — Moderna
-
2021-03-27
Registered in v-safe
-
2021-03-27
Dose 2 — Moderna
- 2021-03-27
-
2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-04-25
- 2021-05-01
- 2021-05-09
- 2021-06-26
- 2021-09-25
-
2021-10-27
Dose 3 — Moderna
- 2021-10-27
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Hypersomnia — Feeling: Poor · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: For some reason I slept 12 hoursMedDRA releases: 2024-11 · check-in free text available
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Pain — Feeling: Fair · Site: Pain · Abdominal painFree text: Some slight pain like tightness upon awakening, but dissipated by mid day.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Dyspepsia — Feeling: Good · Site: Pain · Abdominal painFree text: Some mild indigestion since taking the boosterMedDRA releases: 2024-11 · check-in free text available
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Dyspepsia, Flatulence — Feeling: Good · Abdominal painFree text: Indigestion and gas over the last few days which is not usual for me. This seemed to happen since the booster shot.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Dyspepsia, Flatulence — Feeling: GoodFree text: Still some indigestion and gas but less than beforeMedDRA releases: 2024-11 · check-in free text available
- 2021-11-03
- 2021-11-11
- 2021-11-19
-
2021-11-24
Survey response — day 28, dose 3MedDRA: Dyspepsia, Flatulence — Feeling: FairFree text: Since the booster I have had intermittent mild gas and sometimes indehestionMedDRA releases: 2024-11 · check-in free text available
- 2021-12-01
- 2021-12-08
- 2022-01-26
-
2022-04-22
Dose 4 — Moderna
- 2022-04-22
-
2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-04-27
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-07-22
-
2022-09-16
Dose 5 — ModernaCo-administered: Flu
-
2022-09-17
Survey response — days 1–6 daily, dose 5MedDRA: Chills — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Slight chills last night about 8 hours after the injection, but rather mild and only lasted about 10 minutesMedDRA releases: 2024-11 · check-in free text available
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-23
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-12-16
- 2023-03-17
-
2023-04-28
Dose 6 — Moderna
-
2023-05-01
Health check-in — days 1–6 daily, dose 6Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2023-05-02
- 2023-05-03
- 2023-05-04
- 2023-05-05
- 2023-05-13
- 2023-05-19
- 2023-05-26
- 2023-06-02
- 2023-06-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-27 | Moderna | |
| 2 | 2021-03-27 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-22 | Moderna | No |
| 5 | 2022-09-16 | Moderna | Flu |
| 6 | 2023-04-28 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): For some reason I slept 12 hours
Systemic reaction (other): Some slight pain like tightness upon awakening, but dissipated by mid day.
Systemic reaction (other): Some mild indigestion since taking the booster
Systemic reaction (other): Indigestion and gas over the last few days which is not usual for me. This seemed to happen since the booster shot.
Systemic reaction (other): Still some indigestion and gas but less than before
Release 10 — day 28, dose 3
Symptoms: Since the booster I have had intermittent mild gas and sometimes indehestion
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Slight chills last night about 8 hours after the injection, but rather mild and only lasted about 10 minutes
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 | Dyspepsia | · | · | ✓ |
| SD | Flatulence | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Dyspepsia | · | · | ✓ |
| SRO | Flatulence | · | · | ✓ |
| SRO | Hypersomnia | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release