2J8-24240-49963
2 vaccinations
5 coded responses
20 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 344 / FL
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-17
Dose 1 — Moderna
-
2021-02-18
Registered in v-safe
-
2021-02-18
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Dizziness within 10 minutes of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
-
2021-02-26
Survey response — day 7, dose 1MedDRA: Pre-existing disease — Feeling: Good · Fatigue or tirednessFree text: I have a mohs surgery scheduled for the 2nd of March and a heart cath on the 8th. I hope all goes well with these procedures.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
-
2021-03-10
Survey response — day 21, dose 1MedDRA: Pre-existing disease — Feeling: GoodFree text: Noncovid related heart cath procedure went well with a stent successfully placed on Monday , March 8. Presently Recovering with a new prescription- Brilinta.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-17
Dose 2 — Moderna
- 2021-03-20
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-31
-
2021-04-07
Survey response — day 21, dose 2MedDRA: Angina pectoris — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Noncovid related anginaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-06-16
- 2021-09-15
-
2022-02-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-03-17
Survey response — 12 months, dose 2MedDRA: Angina pectoris, Catheterisation cardiac abnormal, Coronary arterial stent insertion — Feeling: Good · Be unable to do your normal daily activitiesFree text: Persistent Angina that was professionally remedied by the (b)(6) Clinic with a special stent implanted via heart cathMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-17 | Moderna | |
| 2 | 2021-03-17 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Dizziness within 10 minutes of injection
Release 4 — day 7, dose 1
Systemic reaction (other): I have a mohs surgery scheduled for the 2nd of March and a heart cath on the 8th. I hope all goes well with these procedures.
Release 5 — day 21, dose 1
Symptoms: Noncovid related heart cath procedure went well with a stent successfully placed on Monday , March 8. Presently Recovering with a new prescription- Brilinta.
Release 7 — day 21, dose 2
Symptoms: Noncovid related angina
Release 11 — 12 months, dose 2
Symptoms: Persistent Angina that was professionally remedied by the (b)(6) Clinic with a special stent implanted via heart cath
redacted (b)(6)
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 | Angina pectoris | ✓ | ✓ | ✓ |
| SD | Catheterisation cardiac abnormal | · | · | ✓ |
| SD | Coronary arterial stent insertion | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release