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34X-30488-57962

2 vaccinations 4 coded responses 10 check-ins 4 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
811 / CO
Registered
2021-02-20
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-21
    Dose 1 — Moderna
  2. 2021-02-19
    Dose 2 — Moderna
  3. 2021-02-20
    Registered in v-safe
  4. 2021-02-20
    Survey response — days 1–6 daily, dose 2
    MedDRA: Asthenia, Hospitalisation, Oxygen therapy, SARS-CoV-2 test positive — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: I tested positive for Covid 5 days after the first shot. Was hospitalized and became oxygen dependent. 1.5 L. Had weaned to 1 liter. Last night to weak to walk to bathroom and had to turn Oxygen to 3 liters to get back to 90 percent. Is this normal. Vaccination clinic was on a Friday so no one can help.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-21
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oxygen saturation abnormal — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Still need 1.5 L oxygen up from 1 L
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-02-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-02-28
    Survey response — day 7, dose 2
    MedDRA: Eye pain — Feeling: Fair · Headache
    Free text: Eyes also hurt
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-14
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  11. 2021-03-21
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  12. 2021-03-28
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  13. 2022-02-22
    Survey response — 12 months, dose 2
    MedDRA: COVID-19, Emergency care, Medical counselling — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Had Covid again. Had IV and Decadron shot that was Dec 28 · Healthcare visit (other): House call from health care provider
    MedDRA releases: 2024-11 · check-in free text available
  14. 2022-02-22
    Report sent to call center — 12 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  15. 2022-03-21

Vaccinations

DoseDateManufacturerCo-administered
12021-01-21Moderna
22021-02-19Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): I tested positive for Covid 5 days after the first shot. Was hospitalized and became oxygen dependent. 1.5 L. Had weaned to 1 liter. Last night to weak to walk to bathroom and had to turn Oxygen to 3 liters to get back to 90 percent. Is this normal. Vaccination clinic was on a Friday so no one can help.

2021-02-21

Systemic reaction (other): Still need 1.5 L oxygen up from 1 L

Release 4 — day 7, dose 2

2021-02-28

Systemic reaction (other): Eyes also hurt

Release 11 — 12 months, dose 2

2022-02-22

Symptoms: Had Covid again. Had IV and Decadron shot that was Dec 28
Healthcare visit (other): House call from health care provider

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

FieldPreferred term2021-092023-042024-11
HCVOMedical counselling · · ✓
SDCOVID-19 · · ✓
SDEmergency care · · ✓
SROAsthenia ✓ ✓ ✓
SROEye pain ✓ ✓ ✓
SROHospitalisation ✓ ✓ ✓
SROOxygen saturation abnormal ✓ ✓ ✓
SROOxygen therapy ✓ ✓ ✓
SROSARS-CoV-2 test positive ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release