36Q-91099-02669
2 vaccinations
1 coded response
12 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 335 / FL
- Registered
- 2021-09-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-08-10
Dose 1 — Moderna
-
2021-09-04
Registered in v-safe
- 2021-09-04
-
2021-09-05
Dose 2 — Moderna
- 2021-09-07
- 2021-09-08
- 2021-09-09
- 2021-09-10
- 2021-09-11
- 2021-09-14
- 2021-09-19
-
2021-09-27
Survey response — day 21, dose 2MedDRA: Anxiety, Chest pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Pain in the upper left chest area (Same side the shot was given on that arm). Was originally worried it is a heart issue. Symptoms didn't start until about a week after the 2nd shot. The pain was a harsh shock, followed by days of soreness. · Healthcare visit (other): I should of wen, but I opted not to. Didn't want it to be a false-alarm. I'll try to hydrate more and see if I get better. If not, I need to get checked out probably, just in case it's heart-related.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-27
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-09-28
- 2021-10-10
- 2021-10-17
- 2021-12-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-10 | Moderna | No |
| 2 | 2021-09-05 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 9 — day 21, dose 2
Symptoms: Pain in the upper left chest area (Same side the shot was given on that arm). Was originally worried it is a heart issue. Symptoms didn't start until about a week after the 2nd shot. The pain was a harsh shock, followed by days of soreness.
Healthcare visit (other): I should of wen, but I opted not to. Didn't want it to be a false-alarm. I'll try to hydrate more and see if I get better. If not, I need to get checked out probably, just in case it's heart-related.
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 | Unevaluable event | · | · | ✓ |
| SD | Anxiety | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release