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ZEV-32522-99047

3 vaccinations 5 coded responses 38 check-ins 5 free-text entries 0 call cases
Sex
Male
Age at first dose
56-60
ZIP prefix
813 / CO
Registered
2020-12-30
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2020-12-30
    Registered in v-safe
  2. 2020-12-31
    Dose 1 — Moderna
  3. 2020-12-31
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-01
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site bruising, Injection site discomfort, Injection site pain — Feeling: Good · Site: Pain
    Free text: General bruised feeling sensitivity within 3”to 4” of injection site. Rather tender; about same as felt with a Tetanus vaccination.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site bruising, Injection site pain — Feeling: Good · Site: Pain
    Free text: Bruised feeling at injection is dissipating; still tender to touch/pressure.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-01-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-07
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-14
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-01-21
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-01-28
    Dose 2 — Moderna
  13. 2021-01-28
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  14. 2021-01-29
    Survey response — days 1–6 daily, dose 2
    MedDRA: Headache — Feeling: Fair · Site: Pain · Headache
    Free text: Headache evidenced about 7 hours post vaccination and has not subsided.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-01-30
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  16. 2021-01-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-02-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-02-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-02-04
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-02-11
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-02-18
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-02-25
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-04
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-11
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-04-29
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-07-29
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-10-23
    Dose 3 — Moderna
  29. 2021-10-23
    Health check-in — day 0, dose 3
    Feeling: Good · None
    Adult check-in
  30. 2021-10-24
    Survey response — days 1–6 daily, dose 3
    MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: Mild to moderate. Presented about 10-12 hrs post vaccination.
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-10-25
    Survey response — days 1–6 daily, dose 3
    MedDRA: Back pain, Lymph node pain, Renal pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches
    Free text: Moderate ache in lower back kidney area. Lymph node beneath vaccine arm very tender
    MedDRA releases: 2024-11 · check-in free text available
  32. 2021-10-26
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  33. 2021-10-27
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Muscle or body aches
    Adult check-in
  34. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Muscle or body aches
    Adult check-in
  35. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-10-30
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  37. 2021-11-06
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  38. 2021-11-13
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  39. 2021-11-20
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-11-27
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  41. 2021-12-04
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  42. 2022-01-22
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12020-12-31Moderna
22021-01-28Moderna
32021-10-23Moderna No

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): General bruised feeling sensitivity within 3”to 4” of injection site. Rather tender; about same as felt with a Tetanus vaccination.

2021-01-02

Systemic reaction (other): Bruised feeling at injection is dissipating; still tender to touch/pressure.

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Headache evidenced about 7 hours post vaccination and has not subsided.

Release 10 — days 1–6 daily, dose 3

2021-10-24

Systemic reaction (other): Mild to moderate. Presented about 10-12 hrs post vaccination.

2021-10-25

Systemic reaction (other): Moderate ache in lower back kidney area. Lymph node beneath vaccine arm very tender

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

FieldPreferred term2021-092023-042024-11
SROAdverse reaction · · ✓
SROBack pain · · ✓
SROHeadache ✓ ✓ ✓
SROInjection site bruising ✓ ✓ ✓
SROInjection site discomfort ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROLymph node pain · · ✓
SRORenal pain · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release