3S3-86155-17651
4 vaccinations
4 coded responses
36 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 220 / VA
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Dose 1 — Moderna
-
2021-01-21
Registered in v-safe
-
2021-01-22
Survey response — day 7, dose 1MedDRA: Pre-existing disease — Feeling: Good · Site: PainFree text: That same night after the first shot, I had a moderate atrial fibrillation episode that I hadnt had for a year. Lasted about 5 hours before returning to normal pulse.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-02-04
- 2021-02-11
-
2021-02-16
Dose 2 — Moderna
- 2021-02-18
-
2021-02-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-17
-
2021-10-25
Dose 3 — Moderna
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Fatigue, Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessFree text: Moderate injection site itching, redness, slight swelling started late yesterday. Applying ice compacts this morning, itching appears to be lessening. Still some fatigue but improved enough will try some outdoor walking later today.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: Pain, Redness, ItchingFree text: No - overall better today.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-11
Dose 4 — Moderna
- 2022-04-25
-
2022-05-18
Survey response — day 35, dose 4MedDRA: Atrial fibrillation, Dyspnoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: A little more short of breath at times. Had Afib episode May 14 2022MedDRA releases: 2024-11 · check-in free text available
-
2022-05-18
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-05-19
- 2022-05-23
- 2022-07-11
- 2022-10-10
- 2023-04-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-11 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 2 — day 7, dose 1
Systemic reaction (other): That same night after the first shot, I had a moderate atrial fibrillation episode that I hadnt had for a year. Lasted about 5 hours before returning to normal pulse.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Moderate injection site itching, redness, slight swelling started late yesterday. Applying ice compacts this morning, itching appears to be lessening. Still some fatigue but improved enough will try some outdoor walking later today.
Systemic reaction (other): No - overall better today.
Release 11 — day 35, dose 4
Symptoms: A little more short of breath at times. Had Afib episode May 14 2022
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 | Atrial fibrillation | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Injection site erythema | · | · | ✓ |
| SRO | Injection site pruritus | · | · | ✓ |
| SRO | Injection site swelling | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release