3H6-27445-91551
1 vaccination
3 coded responses
12 check-ins
3 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 385 / TN
- Registered
- 2021-02-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-25
Dose 1 — Moderna
-
2021-02-26
Registered in v-safe
-
2021-02-26
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-27
- 2021-02-28
- 2021-03-03
- 2021-03-04
- 2021-03-11
- 2021-03-18
-
2021-03-25
Survey response — day 28, dose 1MedDRA: Office visit, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I injured my back on Saturday and have had extremel sciatic pain. I started a steroid pack and was advised to wait until getting my second dose. · Healthcare visit (other): My doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-25
Report sent to call center — day 28, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-01
Survey response — day 35, dose 1MedDRA: Back pain, Office visit — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I hurt my back and was on a steroid pack...the reason for the delay on the second shot. The steroids are wearing off, so the back pain has returned. No symptoms related to COVID · Healthcare visit (other): My doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-01
Report sent to call center — day 35, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-10
-
2021-05-29
Survey response — 3 months, dose 1MedDRA: Chills, Cough, Fatigue, Headache, Pyrexia — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesFree text: I had a slight cough, fever and chills, headache and extreme fatigue for 6 daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-07
Call successfulDoes not wish to fill out VAERS report
- 2021-08-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 6 — day 28, dose 1
Symptoms: I injured my back on Saturday and have had extremel sciatic pain. I started a steroid pack and was advised to wait until getting my second dose.
Healthcare visit (other): My doctor
Release 6 — day 35, dose 1
Symptoms: I hurt my back and was on a steroid pack...the reason for the delay on the second shot. The steroids are wearing off, so the back pain has returned. No symptoms related to COVID
Healthcare visit (other): My doctor
Release 8 — 3 months, dose 1
Symptoms: I had a slight cough, fever and chills, headache and extreme fatigue for 6 days
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 | Back pain | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release