Y53-23102-61590
2 vaccinations
3 coded responses
26 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 224 / VA
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Registered in v-safe
-
2021-03-16
Dose 1 — Moderna
- 2021-03-16
- 2021-03-17
- 2021-03-18
-
2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: GoodFree text: Soreness in arm where I received shot diminishingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-21
- 2021-03-22
-
2021-03-23
Survey response — day 7, dose 1MedDRA: Cardiac flutter, Heart rate increased — Feeling: Good · Fatigue or tirednessFree text: I dont think it was vaccine related, In healthy no heart issues, in store this morning had a heart flutter and was cycling today, wearing a heart monitor and my heart rate spiked, going to see Dr. tmmrw morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-30
- 2021-04-06
- 2021-04-13
-
2021-04-15
Dose 2 — Moderna
- 2021-04-15
-
2021-04-16
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Receive second dose of vaccine 11 AM yesterday. About 8pm experienced the listed symptoms, they were mild..went to bed woke up, symptoms gone feeling normal all dayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-21
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-07-15
- 2021-10-14
- 2022-04-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-15 | Moderna |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Soreness in arm where I received shot diminishing
Release 6 — day 7, dose 1
Systemic reaction (other): I dont think it was vaccine related, In healthy no heart issues, in store this morning had a heart flutter and was cycling today, wearing a heart monitor and my heart rate spiked, going to see Dr. tmmrw morning
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Receive second dose of vaccine 11 AM yesterday. About 8pm experienced the listed symptoms, they were mild..went to bed woke up, symptoms gone feeling normal all day
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 | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Cardiac flutter | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release