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
-
2021-01-21
Dose 1 — Moderna
-
2021-02-19
Dose 2 — Moderna
-
2021-02-20
Registered in v-safe
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2021-02-20
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree 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
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2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Oxygen saturation abnormal — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Still need 1.5 L oxygen up from 1 LMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-22
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-25
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2021-02-28
Survey response — day 7, dose 2MedDRA: Eye pain — Feeling: Fair · HeadacheFree text: Eyes also hurtMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-14
- 2021-03-21
- 2021-03-28
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2022-02-22
Survey response — 12 months, dose 2MedDRA: COVID-19, Emergency care, Medical counselling — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Had Covid again. Had IV and Decadron shot that was Dec 28 · Healthcare visit (other): House call from health care providerMedDRA releases: 2024-11 · check-in free text available
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2022-02-22
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-03-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-19 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 4 — days 1–6 daily, dose 2
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.
Systemic reaction (other): Still need 1.5 L oxygen up from 1 L
Release 4 — day 7, dose 2
Systemic reaction (other): Eyes also hurt
Release 11 — 12 months, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Medical counselling | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Hospitalisation | ✓ | ✓ | ✓ |
| SRO | Oxygen saturation abnormal | ✓ | ✓ | ✓ |
| SRO | Oxygen therapy | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release