2FH-26403-36205
2 vaccinations
3 coded responses
22 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 281 / NC
- Registered
- 2021-01-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-10
Registered in v-safe
-
2021-01-10
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessAdult check-in
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-22
- 2021-01-29
-
2021-02-05
Dose 2 — Moderna
- 2021-02-05
-
2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Blood pressure increased — Feeling: Poor · 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: Elevated BPMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
-
2021-02-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Fatigue or tirednessAdult check-in
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
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2021-08-08
Survey response — 6 months, dose 2MedDRA: Aortic aneurysm, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Have been diagnosed with aortic aneurysm blood pressure had been stable until had Covid and after Covid BP and pulse was hit and saw new cardiologist and he found it have to have yearly chest CT to make sure it doesnt get any larger 3.7 cm · Healthcare visit (other): Saw cardiologist had complete work upMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-08
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-12-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-02-05
Survey response — 12 months, dose 2MedDRA: Gastroenteritis viral, Muscle rupture, Pre-existing disease, Pyrexia, Rotator cuff repair, Rotator cuff syndrome, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, 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: Had fever with booster 102 had stomach virus prior to booster and fever 103.9 Covid test was neg at time of virus . Had surgery for rotator cuff and bicep tear. BP stable and size of aortic aneurysm stable also BP was elevated with Covid Aug 2020MedDRA releases: 2024-11 · check-in free text available
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2022-02-05
Report sent to call center — 12 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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-02-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-05 | Moderna |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Elevated BP
Release 9 — 6 months, dose 2
Symptoms: Have been diagnosed with aortic aneurysm blood pressure had been stable until had Covid and after Covid BP and pulse was hit and saw new cardiologist and he found it have to have yearly chest CT to make sure it doesnt get any larger 3.7 cm
Healthcare visit (other): Saw cardiologist had complete work up
Release 11 — 12 months, dose 2
Symptoms: Had fever with booster 102 had stomach virus prior to booster and fever 103.9 Covid test was neg at time of virus . Had surgery for rotator cuff and bicep tear. BP stable and size of aortic aneurysm stable also BP was elevated with Covid Aug 2020
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 | ✓ | · | ✓ |
| SD | Aortic aneurysm | ✓ | · | ✓ |
| SD | Gastroenteritis viral | · | · | ✓ |
| SD | Muscle rupture | · | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rotator cuff repair | · | · | ✓ |
| SD | Rotator cuff syndrome | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Blood pressure increased | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release