ZHV-49047-91448
5 vaccinations
4 coded responses
42 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 923 / CA
- Registered
- 2021-01-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
35T-29166-60625
Other · Female · 2021-08-17
Timeline
-
2021-01-19
Registered in v-safe
-
2021-01-19
Dose 1 — Moderna
- 2021-01-19
- 2021-01-22
-
2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: 1st day slight pain at injection site. 2nd day moderate pain. 3rd started feeling better. 4th day pain went away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
- 2021-01-26
- 2021-02-02
- 2021-02-09
-
2021-02-16
Dose 2 — Moderna
- 2021-02-16
-
2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-18
-
2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Night sweats — Feeling: GoodFree text: Night sweatsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-17
-
2021-10-23
Dose 3 — Moderna
-
2021-10-24
Survey response — days 1–6 daily, dose 3MedDRA: Brain fog, Feeling abnormal — Feeling: Fair · HeadacheFree text: My head feels for lack of better words foggy, dinghy. Woke up this morning 5:30 AM didn't feel real good was back asleep by 8 o'clock till nine and feel generally a little better now.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-25
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-06
-
2021-11-13
Survey response — day 21, dose 3MedDRA: Back pain, Chest pain — Feeling: GoodFree text: About 5 days ago I started experiencing pains in my upper torso front and back. Seems to be coming from the center of my body. I don't know if it's muscular or what. Just wanted to let you know.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2022-01-22
-
2022-03-30
Dose 4 — Moderna
- 2022-04-23
- 2022-05-14
- 2022-06-29
-
2022-09-12
Dose 5 — Moderna
- 2022-09-26
- 2022-10-03
- 2022-12-12
- 2023-03-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-03-30 | Moderna | No |
| 5 | 2022-09-12 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): 1st day slight pain at injection site. 2nd day moderate pain. 3rd started feeling better. 4th day pain went away.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Night sweats
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): My head feels for lack of better words foggy, dinghy. Woke up this morning 5:30 AM didn't feel real good was back asleep by 8 o'clock till nine and feel generally a little better now.
Release 10 — day 21, dose 3
Symptoms: About 5 days ago I started experiencing pains in my upper torso front and back. Seems to be coming from the center of my body. I don't know if it's muscular or what. Just wanted to let you know.
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 | Back pain | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Feeling abnormal | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release