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27Z-33214-81009

2 vaccinations 2 coded responses 20 check-ins 2 free-text entries 2 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
531 / WI
Registered
2021-01-29
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-29
    Registered in v-safe
  2. 2021-01-29
    Dose 1 — Moderna
  3. 2021-01-29
    Health check-in — day 0, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  4. 2021-01-31
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-02-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-02
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-05
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-13
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-19
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-24
    Dose 2 — Moderna
  12. 2021-02-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  13. 2021-02-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  14. 2021-02-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  15. 2021-03-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-03-03
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-10
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-17
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-03-24
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-03-31
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-04-07
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-26
    Survey response — 3 months, dose 2
    MedDRA: Ankle operation, Arthropathy, Artificial crown procedure, Dental implantation, Dental restoration failure, Device physical property issue, Fungal skin infection, Office visit, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Ankle problems which will require surgery 6/23/2021. Tooth crown fell off. Dental implant in progress. Fungal rash, currently being treated. No COVID-19 symptoms experienced. · Healthcare visit (other): Doctor visits. 4 different doctors.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-05-26
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  24. 2021-08-25
    Survey response — 6 months, dose 2
    MedDRA: Foot operation, Office visit, Physiotherapy, Weight bearing difficulty — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization
    Free text: Symptoms: Surgery to rebuild left foot. Complicated surgery, with long recovery, including one month with no weight bearing. Not caused by an accident. · Healthcare visit (other): Day surgery only, with substantial after visits and physical therapy.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  25. 2021-08-25
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  26. 2021-08-27

Vaccinations

DoseDateManufacturerCo-administered
12021-01-29Moderna
22021-02-24Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 8 — 3 months, dose 2

2021-05-26

Symptoms: Ankle problems which will require surgery 6/23/2021. Tooth crown fell off. Dental implant in progress. Fungal rash, currently being treated. No COVID-19 symptoms experienced.
Healthcare visit (other): Doctor visits. 4 different doctors.

Release 9 — 6 months, dose 2

2021-08-25

Symptoms: Surgery to rebuild left foot. Complicated surgery, with long recovery, including one month with no weight bearing. Not caused by an accident.
Healthcare visit (other): Day surgery only, with substantial after visits and physical therapy.

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
HCVOOffice visit ✓ ✓ ✓
HCVOPhysiotherapy ✓ · ✓
SDAnkle operation ○ ✓ ○
SDArthropathy ✓ · ✓
SDArtificial crown procedure ○ ✓ ○
SDDental implantation ✓ · ✓
SDDental restoration failure ✓ · ✓
SDDevice physical property issue ○ ✓ ○
SDFoot operation ✓ · ✓
SDFungal skin infection ✓ ✓ ✓
SDPre-existing disease ○ ✓ ○
SDWeight bearing difficulty ✓ · ✓

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