ZUH-34341-70460
3 vaccinations
2 coded responses
33 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 773 / TX
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-02
Registered in v-safe
-
2021-03-02
Dose 1 — Moderna
- 2021-03-02
- 2021-03-03
- 2021-03-05
- 2021-03-06
-
2021-03-07
Health check-in — days 1–6 daily, dose 1Feeling: Good · Joint pains, Muscle or body achesAdult check-in
- 2021-03-08
- 2021-03-09
- 2021-03-16
- 2021-03-24
- 2021-03-31
-
2021-04-01
Dose 2 — Moderna
-
2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Erythema, Headache, Injection site erythema, Injection site pain, Injection site pruritus, Pain, Peripheral swelling, Pyrexia — Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tirednessFree text: Mild pain on DAY 1 at injection site. 30 hrs after shot had fever of 100.5, chills, very achy, headache, arm red and swollen, @72 hrs no more side effects besides at injection site. Swelling at injection site has lessened, but still red and itchy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
-
2021-05-06
Survey response — day 35, dose 2MedDRA: Blood urine present — Feeling: GoodFree text: About a week or so ago I had a little bit of blood in my urine. About 5ml worth. Bright red blood. No pain or discomfort. Hasn't happened again. May not be related to vaccine?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-13
- 2021-07-01
- 2021-10-02
-
2021-11-08
Dose 3 — Moderna
- 2021-11-08
-
2021-11-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-11
- 2021-11-12
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-15
- 2021-12-20
- 2022-02-07
- 2022-05-09
- 2022-11-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-08 | Moderna | No |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Mild pain on DAY 1 at injection site. 30 hrs after shot had fever of 100.5, chills, very achy, headache, arm red and swollen, @72 hrs no more side effects besides at injection site. Swelling at injection site has lessened, but still red and itchy.
Release 8 — day 35, dose 2
Symptoms: About a week or so ago I had a little bit of blood in my urine. About 5ml worth. Bright red blood. No pain or discomfort. Hasn't happened again. May not be related to vaccine?
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 | Blood urine present | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release