3UT-27515-85459
1 vaccination
4 coded responses
16 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 921 / CA
- Registered
- 2021-02-02
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-02
Registered in v-safe
-
2021-02-02
Dose 1 — Moderna
- 2021-02-02
-
2021-02-03
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Joint pains, Muscle or body achesAdult check-in
-
2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Insomnia — Feeling: Good · Site: PainFree text: Difficulty sleepingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Blood glucose increased, Diabetes mellitus, Pre-existing disease, Type 1 diabetes mellitus — Feeling: Fair · Site: Pain · Fever · Chills, DiarrheaFree text: Sugar level 357. I am type 1 diabetic with insulin pump and continuous glucose monitor.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-16
- 2021-02-24
- 2021-03-03
- 2021-03-09
- 2021-03-17
-
2021-05-04
Survey response — 3 months, dose 1MedDRA: Body temperature increased, Chills — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Severe reaction to the second dose of the vaccine after 6 days. Severe chillls, shivers, temperature of 102, and sugar levels approaching 400 for two days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-04
Report sent to call center — 3 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-03
Survey response — 6 months, dose 1MedDRA: Asthenia, Self-medication, Sensitisation, Sneezing — Feeling: GoodFree text: My nose has become extra sensitive. I sneeze at the slightest movement of air in my apartment. Allergy medication helps for a while. I also feel weaker.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2022-02-02
- 2022-05-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-02 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Difficulty sleeping
Systemic reaction (other): Sugar level 357. I am type 1 diabetic with insulin pump and continuous glucose monitor.
Release 8 — 3 months, dose 1
Symptoms: Severe reaction to the second dose of the vaccine after 6 days. Severe chillls, shivers, temperature of 102, and sugar levels approaching 400 for two days.
Release 9 — 6 months, dose 1
Symptoms: My nose has become extra sensitive. I sneeze at the slightest movement of air in my apartment. Allergy medication helps for a while. I also feel weaker.
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 | Asthenia | ✓ | · | ✓ |
| SD | Body temperature increased | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | · | ✓ |
| SD | Sensitisation | ✓ | · | ✓ |
| SD | Sneezing | ✓ | · | ✓ |
| SRO | Blood glucose increased | ✓ | ✓ | ✓ |
| SRO | Diabetes mellitus | · | · | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Type 1 diabetes mellitus | ✓ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release