2SZ-10143-40487
3 vaccinations
5 coded responses
23 check-ins
5 free-text entries
4 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 286 / NC
- Registered
- 2021-02-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-24
Registered in v-safe
-
2021-02-24
Dose 1 — Moderna
- 2021-02-24
- 2021-02-28
-
2021-03-02
Survey response — days 1–6 daily, dose 1MedDRA: Asthma, Chest discomfort — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Asthma- chest tightnessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-02
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-03
- 2021-03-10
-
2021-03-17
Survey response — day 21, dose 1MedDRA: Asthma, Pre-existing disease — Feeling: FairFree text: Some exacerbation of my asthma symptoms - not unusual for this time of year for me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-23
Dose 2 — Moderna
- 2021-03-24
- 2021-03-28
- 2021-03-30
- 2021-04-08
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-06-23
- 2021-09-21
- 2021-09-21
- 2021-09-24
- 2021-09-24
-
2021-10-15
Dose 3 — Moderna
-
2021-10-29
Survey response — day 14, dose 3MedDRA: Asthenia, Catheterisation cardiac abnormal, Coronary arterial stent insertion, Hospitalisation, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · HospitalizationFree text: Cardiac catheterization on 10/27/2021 - 2 stents placed. No problems other than some reduced energy. I was tested at (b)(6) Medical Center for COVID-19 and the test was negative. I stayed one night in the hospital.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-29
Report sent to call center — day 14, dose 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
-
2021-11-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-05
-
2021-11-14
Survey response — day 28, dose 3MedDRA: Adverse drug reaction, Chest discomfort, Chest pain, Dyspnoea, Emergency care, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Chest tightness and moderate pain accompanied by shortness of breath on 11/12/2021. Went to local ER and tested negative for COVID-19. They believe that my symptoms are related to a side effect of a new prescription: Brilinta. Switched to Plavix.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-14
Report sent to call center — day 28, dose 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-11-15
- 2021-11-19
- 2021-11-28
-
2022-01-14
Survey response — 3 months, dose 3MedDRA: Coronary arterial stent insertion — 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 · HospitalizationFree text: Cardiac catheterization 10/27/2021. 2 stents in right coronary artery and circumflex artery.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-14
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
- 2022-01-17
- 2022-01-19
- 2022-01-19
- 2022-04-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-24 | Moderna | |
| 2 | 2021-03-23 | Moderna | |
| 3 | 2021-10-15 | Moderna | No |
Call center
4 call center cases
2 successful · 2 unsuccessful
1 wait over 3 months for a first call
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Asthma- chest tightness
Release 5 — day 21, dose 1
Symptoms: Some exacerbation of my asthma symptoms - not unusual for this time of year for me.
Release 10 — day 14, dose 3
Symptoms: Cardiac catheterization on 10/27/2021 - 2 stents placed. No problems other than some reduced energy. I was tested at (b)(6) Medical Center for COVID-19 and the test was negative. I stayed one night in the hospital.
redacted (b)(6)
Release 10 — day 28, dose 3
Symptoms: Chest tightness and moderate pain accompanied by shortness of breath on 11/12/2021. Went to local ER and tested negative for COVID-19. They believe that my symptoms are related to a side effect of a new prescription: Brilinta. Switched to Plavix.
Release 10 — 3 months, dose 3
Symptoms: Cardiac catheterization 10/27/2021. 2 stents in right coronary artery and circumflex artery.
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 | Adverse drug reaction | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Asthma | ✓ | ✓ | ✓ |
| SD | Catheterisation cardiac abnormal | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Coronary arterial stent insertion | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Asthma | ✓ | ✓ | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release