33B-32829-10433
5 vaccinations
13 coded responses
48 check-ins
12 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 600 / IL
- Registered
- 2021-03-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-08
Registered in v-safe
-
2021-03-08
Dose 1 — Moderna
- 2021-03-08
- 2021-03-09
-
2021-03-10
Survey response — days 1–6 daily, dose 1MedDRA: Pyrexia — Feeling: Good · FeverFree text: About 32 hrs after my shot, I felt feverish for an hour. But then only off and on, and not bad.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-22
- 2021-03-29
-
2021-04-05
Dose 2 — Moderna
- 2021-04-05
-
2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: Confusional state — Feeling: Fair · Fever · Headache, Muscle or body achesFree text: Got confused with my times and my streets.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Survey response — days 1–6 daily, dose 2MedDRA: Confusional state — Feeling: Good · Joint painsFree text: Still getting confused a lot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Confusional state — Feeling: GoodFree text: Less confused today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-09
Survey response — days 1–6 daily, dose 2MedDRA: Confusional state — Feeling: Good · HeadacheFree text: Still have some confusionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Confusional state — Feeling: GoodFree text: Confusion seems gone.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: GoodFree text: Brain fog gone.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
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2021-04-19
Survey response — day 14, dose 2MedDRA: Feeling abnormal — Feeling: GoodFree text: On 4/16, I just felt bad all day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-07-05
- 2021-10-04
-
2021-10-25
Dose 3 — Moderna
- 2021-10-29
- 2021-10-30
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Headache, Pain — Feeling: GoodFree text: Got my shot on 10/25/21. Felt achy and had a bad headache the next morning til noon.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
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2021-11-08
Survey response — day 14, dose 3MedDRA: Gastrointestinal disorder — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Stomach issues, but may be caused by new medicine (Voltaren).MedDRA releases: 2024-11 · check-in free text available
- 2021-11-15
- 2021-11-22
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2021-11-29
Survey response — day 35, dose 3MedDRA: Unevaluable event — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Could be recurring stomach issues.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-06
- 2022-01-24
-
2022-04-03
Dose 4 — Moderna
- 2022-04-20
- 2022-04-24
- 2022-05-01
- 2022-05-08
- 2022-05-15
- 2022-07-03
-
2022-09-13
Dose 5 — Moderna
- 2022-10-01
- 2022-10-04
- 2022-10-11
-
2022-10-18
Survey response — day 35, dose 5MedDRA: Adverse reaction, Feeling abnormal, Feeling hot, Headache, SARS-CoV-2 test negative, Self-medication — Feeling: FairFree text: Yesterday: felt feverish (but no fever), slight headache (took Tylenol), and felt blah. Today: I feel better, but not 100%. Negative at-home Covid test last nite.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-25
- 2022-12-13
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2023-03-14
Survey response — 6 months, dose 5MedDRA: COVID-19 — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-14
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-03-15
-
2023-03-15
Callback requested for05:30PM ET
-
2023-03-15
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-08 | Moderna | |
| 2 | 2021-04-05 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-03 | Moderna | No |
| 5 | 2022-09-13 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): About 32 hrs after my shot, I felt feverish for an hour. But then only off and on, and not bad.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Got confused with my times and my streets.
Systemic reaction (other): Still getting confused a lot.
Systemic reaction (other): Less confused today.
Systemic reaction (other): Still have some confusion
Systemic reaction (other): Confusion seems gone.
Systemic reaction (other): Brain fog gone.
Release 7 — day 14, dose 2
Symptoms: On 4/16, I just felt bad all day.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Got my shot on 10/25/21. Felt achy and had a bad headache the next morning til noon.
Release 10 — day 14, dose 3
Symptoms: Stomach issues, but may be caused by new medicine (Voltaren).
Release 10 — day 35, dose 3
Symptoms: Could be recurring stomach issues.
Release 12 — day 35, dose 5
Symptoms: Yesterday: felt feverish (but no fever), slight headache (took Tylenol), and felt blah. Today: I feel better, but not 100%. Negative at-home Covid test last nite.
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 reaction | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Feeling hot | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Confusional state | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release