39X-10969-86207
3 vaccinations
5 coded responses
25 check-ins
5 free-text entries
4 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 300 / GA
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Dose 1 — Moderna
-
2021-01-28
Registered in v-safe
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-02-23
-
2021-02-27
Dose 2 — Moderna
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Musculoskeletal stiffness — Feeling: GoodFree text: Stuffiness in chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
-
2021-05-29
Survey response — 3 months, dose 2MedDRA: Influenza, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Had flu/cold symptoms for 6 days. Tested negative on rapid and pcr test 5/26.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-29
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-31
Survey response — 6 months, dose 2MedDRA: Extrasystoles, Office visit, Palpitations — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Palpations and skipped beats · Healthcare visit (other): In office with cardiologistMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-31
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-02
-
2022-01-04
Dose 3 — Moderna
-
2022-03-01
Survey response — 12 months, dose 2MedDRA: Electrocardiogram abnormal, Extrasystoles, Office visit, Palpitations — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: After both second shot and booster I experienced palpitations and skipped beats. Both times wore halter 3-4 weeks. Recorded an abnormal EKG about 5 weeks ago. Seeing cardiologist tomorrow. · Healthcare visit (other): Office visitMedDRA releases: 2024-11 · check-in free text available
-
2022-03-01
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)
- 2022-03-04
-
2022-04-05
Survey response — 3 months, dose 3MedDRA: Office visit, Supraventricular extrasystoles, Tachycardia, Ventricular extrasystoles — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: PVC's. & PAC's. Frequent tachycardia · Healthcare visit (other): CardiologistMedDRA releases: 2024-11 · check-in free text available
-
2022-04-05
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2022-04-06
- 2022-07-05
- 2023-01-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-27 | Moderna | |
| 3 | 2022-01-04 | Moderna | No |
Call center
4 call center cases
4 unsuccessful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Stuffiness in chest
Release 8 — 3 months, dose 2
Symptoms: Had flu/cold symptoms for 6 days. Tested negative on rapid and pcr test 5/26.
Release 9 — 6 months, dose 2
Symptoms: Palpations and skipped beats
Healthcare visit (other): In office with cardiologist
Release 11 — 12 months, dose 2
Symptoms: After both second shot and booster I experienced palpitations and skipped beats. Both times wore halter 3-4 weeks. Recorded an abnormal EKG about 5 weeks ago. Seeing cardiologist tomorrow.
Healthcare visit (other): Office visit
Release 11 — 3 months, dose 3
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 | Office visit | ✓ | · | ✓ |
| SD | Electrocardiogram abnormal | · | · | ✓ |
| SD | Extrasystoles | ✓ | · | ✓ |
| SD | Influenza | ✓ | ✓ | ✓ |
| SD | Palpitations | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Supraventricular extrasystoles | · | · | ✓ |
| SD | Tachycardia | · | · | ✓ |
| SD | Ventricular extrasystoles | · | · | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release