3F5-62987-56038
4 vaccinations
5 coded responses
26 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 342 / FL
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-10
Dose 1 — Moderna
-
2021-01-11
Registered in v-safe
- 2021-01-11
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-18
- 2021-01-25
- 2021-01-31
-
2021-02-07
Dose 2 — Moderna
- 2021-02-21
-
2021-03-01
Survey response — day 21, dose 2MedDRA: Headache — Feeling: GoodFree text: HeadachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-07
Survey response — day 28, dose 2MedDRA: Neuropathy peripheral, Paraesthesia, Skin burning sensation — Feeling: GoodFree text: Neuropathy in big toe of left foot, i.e., tingling and burning of toe started last night and continued on and off. I have had infrequent tingling of the bottom of my right foot before I had the COVID shot, but it has never been diagnosed by DrMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-15
- 2021-03-22
- 2021-05-09
-
2021-08-08
Survey response — 6 months, dose 2MedDRA: Nerve injury, Office visit, Surgery — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Nerve damage right wrist and elbow. Had surgery. · Healthcare visit (other): Office visits and surgeryMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-08
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-10-23
Dose 3 — Moderna
-
2021-11-26
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-02-07
-
2022-04-12
Dose 4 — Moderna
-
2022-04-18
Survey response — days 1–6 daily, dose 4MedDRA: Headache — Feeling: GoodFree text: Did have headache for a couple of daysMedDRA releases: 2024-11 · check-in free text available
- 2022-04-19
- 2022-04-26
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-07-12
-
2022-10-11
Survey response — 6 months, dose 4MedDRA: Injection site erythema — Feeling: GoodFree text: After booster on Oct 2, arm turned red below injection site.MedDRA releases: 2024-11 · check-in free text available
- 2023-04-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-10 | Moderna | |
| 2 | 2021-02-07 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — day 21, dose 2
Symptoms: Headaches
Release 5 — day 28, dose 2
Symptoms: Neuropathy in big toe of left foot, i.e., tingling and burning of toe started last night and continued on and off. I have had infrequent tingling of the bottom of my right foot before I had the COVID shot, but it has never been diagnosed by Dr
Release 9 — 6 months, dose 2
Symptoms: Nerve damage right wrist and elbow. Had surgery.
Healthcare visit (other): Office visits and surgery
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Did have headache for a couple of days
Release 12 — 6 months, dose 4
Symptoms: After booster on Oct 2, arm turned red below injection site.
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 | ✓ | · | ✓ |
| HCVO | Surgery | ✓ | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site erythema | · | · | ✓ |
| SD | Nerve injury | ✓ | · | ✓ |
| SD | Neuropathy peripheral | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SD | Skin burning sensation | ✓ | ✓ | ✓ |
| SD | Surgery | ✓ | · | ✓ |
| SRO | Headache | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release