29W-13267-37603
5 vaccinations
12 coded responses
64 check-ins
12 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 410 / KY
- Registered
- 2021-03-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-03
Registered in v-safe
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2021-03-03
Dose 1 — Moderna
- 2021-03-03
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2021-03-04
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Fatigue, Hypersomnia — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: I slept 14 hours. Chills were last night. Fatigue was severe last evening - I crashed at 6 pm and slept until 8am and didnt get up until 10 am is getting betterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue, Nausea, Pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Extreme fatigue continued. Onset of pain/aches last evening. Slept 14 hours again. Then napped another 4 hours until 1 pm. Since then Im feeling much better (note: forgot to report nausea on day one that abated and was not present on day 2)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-03-07
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-03-08
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: Good · Fatigue or tirednessFree text: Super mild fatigue today! I feel human again!!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
- 2021-03-10
- 2021-03-17
- 2021-03-24
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2021-03-30
Dose 2 — Moderna
- 2021-03-30
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2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Abnormal dreams, Feeling abnormal — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: Brain fuzziness. Bizarre dreams.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: These symptoms have improved vastly as the day advanced. All moderate in the early hours, theyre now leaning toward mild except for fatigue. I feel so much better!!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-04-03
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2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: Good · Fatigue or tirednessFree text: Brain fog continuesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-06
- 2021-04-13
- 2021-04-22
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-06-29
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2021-09-28
Survey response — 6 months, dose 2MedDRA: Chills, Cough, Epstein-Barr virus test positive, Headache, Liver function test increased, Office visit, Pain, Patient isolation, Pyrexia, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: 9/5 symptoms began full body ache, headache, fever chills. Negative Covid test 9/7 Isolated out of caution. Negative mono and other tests. Elevated LFTs. Cough developed. Follow up additional blood work positive for Epstein Barr · Healthcare visit (other): Initially told to presume positive. After 2 negative Covid tests was seen in office, had an upper right quadrant abdominal ultrasound and chest X-ray.MedDRA releases: 2024-11 · check-in free text available
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2021-09-28
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
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2021-09-30
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2021-11-04
Dose 3 — Moderna
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2021-11-04
Survey response — day 0, dose 3MedDRA: Dizziness, Feeling abnormal — Feeling: Good · Fatigue or tiredness · Be unable to work or attend schoolFree text: Fuzzy/light headedness.MedDRA releases: 2024-11 · check-in free text available
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2021-11-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-11-06
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2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Nausea — Feeling: Good · Site: PainFree text: Had some nausea last night but it resolved overnight.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-08
- 2021-11-09
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-16
- 2022-02-03
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2022-05-05
Dose 4 — Moderna
- 2022-05-05
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2022-05-05
Survey response — day 0, dose 4MedDRA: No adverse event — Feeling: GoodFree text: I just got the shot 15 minutes ago. Nothing to report!MedDRA releases: 2024-11 · check-in free text available
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2022-05-06
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2022-05-07
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue, Pyrexia — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Yesterday after submitting my report I developed a fever of 101 in the evening that broke early this morning. Today, except for some mild lingering fatigue I'm doing great. Seems about 36 hours to normal for me!MedDRA releases: 2024-11 · check-in free text available
- 2022-05-08
- 2022-05-09
- 2022-05-10
- 2022-05-14
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2022-05-19
Survey response — day 14, dose 4MedDRA: Bacterial infection, Cough, Dysphonia, Fatigue, Infection, Lacrimation increased, Respiratory tract infection viral, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Viral respiratory infection and likely secondary bacterial infection. Fatigue, sneezing, runny nose, watery eyes Mon. Tues. developed scratchy throat overnight and strangling type cough and hoarseness Wed. Neg @home C19 on Tues. negative PCR on WedMedDRA releases: 2024-11 · check-in free text available
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2022-05-19
Report sent to call center — day 14, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-05-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-26
- 2022-06-02
- 2022-06-09
- 2022-06-16
- 2022-08-04
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2022-09-22
Dose 5 — Moderna
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2022-09-23
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2022-09-24
- 2022-09-25
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2022-09-26
Health check-in — days 1–6 daily, dose 5Feeling: Good · Fever · Fatigue or tirednessAdult check-in
- 2022-09-29
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-12-22
- 2023-03-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-30 | Moderna | |
| 3 | 2021-11-04 | Moderna | No |
| 4 | 2022-05-05 | Moderna | No |
| 5 | 2022-09-22 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): I slept 14 hours. Chills were last night. Fatigue was severe last evening - I crashed at 6 pm and slept until 8am and didnt get up until 10 am is getting better
Systemic reaction (other): Extreme fatigue continued. Onset of pain/aches last evening. Slept 14 hours again. Then napped another 4 hours until 1 pm. Since then Im feeling much better (note: forgot to report nausea on day one that abated and was not present on day 2)
Systemic reaction (other): Super mild fatigue today! I feel human again!!
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Brain fuzziness. Bizarre dreams.
Systemic reaction (other): These symptoms have improved vastly as the day advanced. All moderate in the early hours, theyre now leaning toward mild except for fatigue. I feel so much better!!
Systemic reaction (other): Brain fog continues
Release 9 — 6 months, dose 2
Symptoms: 9/5 symptoms began full body ache, headache, fever chills. Negative Covid test 9/7 Isolated out of caution. Negative mono and other tests. Elevated LFTs. Cough developed. Follow up additional blood work positive for Epstein Barr
Healthcare visit (other): Initially told to presume positive. After 2 negative Covid tests was seen in office, had an upper right quadrant abdominal ultrasound and chest X-ray.
Release 10 — day 0, dose 3
Systemic reaction (other): Fuzzy/light headedness.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Had some nausea last night but it resolved overnight.
Release 11 — day 0, dose 4
Systemic reaction (other): I just got the shot 15 minutes ago. Nothing to report!
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Yesterday after submitting my report I developed a fever of 101 in the evening that broke early this morning. Today, except for some mild lingering fatigue I'm doing great. Seems about 36 hours to normal for me!
Release 11 — day 14, dose 4
Symptoms: Viral respiratory infection and likely secondary bacterial infection. Fatigue, sneezing, runny nose, watery eyes Mon. Tues. developed scratchy throat overnight and strangling type cough and hoarseness Wed. Neg @home C19 on Tues. negative PCR on Wed cut off by CDC
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| HCVO | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Bacterial infection | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dysphonia | · | · | ✓ |
| SD | Epstein-Barr virus test positive | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Infection | · | · | ✓ |
| SD | Lacrimation increased | · | · | ✓ |
| SD | Liver function test increased | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Patient isolation | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract infection viral | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Abnormal dreams | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Hypersomnia | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release