3JA-25525-58466
3 vaccinations
9 coded responses
13 check-ins
9 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 799 / TX
- Registered
- 2021-09-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-02
Dose 1 — Moderna
-
2021-03-31
Dose 2 — Moderna
-
2021-09-13
Dose 3 — Moderna
-
2021-09-15
Registered in v-safe
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2021-09-15
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-09-16
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
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2021-09-17
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Oropharyngeal pain — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body achesFree text: Dry Cough and sore throatMedDRA releases: 2024-11 · check-in free text available
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2021-09-18
Survey response — days 1–6 daily, dose 3MedDRA: Muscle spasms, Rhinorrhoea — Feeling: Fair · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Escurrimiento nasal y calambresMedDRA releases: 2024-11 · check-in free text available
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2021-09-19
Survey response — days 1–6 daily, dose 3MedDRA: Muscle spasms, Rhinorrhoea — Feeling: Fair · Fever · Chills, Muscle or body achesFree text: Escurrimiento nasal y calambresMedDRA releases: 2024-11 · check-in free text available
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2021-09-20
Survey response — day 7, dose 3MedDRA: Adverse reaction, Muscle spasms, Rhinorrhoea — Feeling: Fair · Fever · Chills, Fatigue or tirednessFree text: Escurrimiento nasal, calambres, como alergiasMedDRA releases: 2024-11 · check-in free text available
- 2021-09-27
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2021-10-04
Survey response — day 21, dose 3MedDRA: Dizziness, Hot flush, Night sweats, Rhinorrhoea — Feeling: FairFree text: Bochornos, sudoracion nocturna, fluido nazal, mareosMedDRA releases: 2024-11 · check-in free text available
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2021-10-11
Survey response — day 28, dose 3MedDRA: Cough, Rhinorrhoea — Feeling: GoodFree text: Running nose and coughMedDRA releases: 2024-11 · check-in free text available
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2021-10-18
Survey response — day 35, dose 3MedDRA: Chills, Nasal congestion, Pain, Skin warm — Feeling: FairFree text: Escalofrios, dolor en todo el cuerpo, cuerpo caliente pero no temperatura, congestion nasalMedDRA releases: 2024-11 · check-in free text available
- 2021-10-25
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2021-12-13
Survey response — 3 months, dose 3MedDRA: Chills, Nasal congestion — Feeling: FairFree text: Escalofrios y congestion nasalMedDRA releases: 2024-11 · check-in free text available
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2022-03-14
Survey response — 6 months, dose 3MedDRA: Abdominal pain, Deafness, Dental caries, Dyspnoea, Memory impairment, Muscle spasms, Visual impairment — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Problemas de memoria, perdida auditiva, caries en dientes y muelas, calambres en manos, piernas y pies, problemas visuales, falta de aire, dolores abdominalesMedDRA releases: 2024-11 · check-in free text available
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2022-03-14
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
- 2022-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | No |
| 2 | 2021-03-31 | Moderna | No |
| 3 | 2021-09-13 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Dry Cough and sore throat
Systemic reaction (other): Escurrimiento nasal y calambres
Systemic reaction (other): Escurrimiento nasal y calambres
Release 9 — day 7, dose 3
Systemic reaction (other): Escurrimiento nasal, calambres, como alergias
Release 10 — day 21, dose 3
Symptoms: Bochornos, sudoracion nocturna, fluido nazal, mareos
Release 10 — day 28, dose 3
Symptoms: Running nose and cough
Release 10 — day 35, dose 3
Symptoms: Escalofrios, dolor en todo el cuerpo, cuerpo caliente pero no temperatura, congestion nasal
Release 10 — 3 months, dose 3
Symptoms: Escalofrios y congestion nasal
Release 11 — 6 months, dose 3
Symptoms: Problemas de memoria, perdida auditiva, caries en dientes y muelas, calambres en manos, piernas y pies, problemas visuales, falta de aire, dolores abdominales
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 |
|---|---|---|---|---|
| SD | Abdominal pain | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Deafness | · | · | ✓ |
| SD | Dental caries | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Hot flush | · | · | ✓ |
| SD | Memory impairment | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Night sweats | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Skin warm | · | · | ✓ |
| SD | Visual impairment | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Muscle spasms | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release