42D-31189-85858
4 vaccinations
2 coded responses
18 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 021 / MA
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-23
Dose 1 — Moderna
-
2021-01-20
Registered in v-safe
-
2021-01-21
Dose 2 — Moderna
-
2021-01-29
Health check-in — day 7, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-04-22
- 2021-07-22
-
2021-11-20
Dose 3 — Moderna
-
2022-01-21
Survey response — 12 months, dose 2MedDRA: Ageusia, Anosmia, COVID-19, Occupational exposure to SARS-CoV-2, Patient isolation, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Covid diagnosis despite booster 11/20/21. Exposed to infected coworker 1/6/21. First symptoms 1/9/21. Positive PCR for covid 1/11/21. Today (1/21) is my 10th day of isolation. Lost smell/taste. Impression Moderna vaccines & booster did not workMedDRA releases: 2024-11 · check-in free text available
-
2022-09-19
Dose 4 — Pfizer-BioNTech
-
2022-09-23
Survey response — days 1–6 daily, dose 4MedDRA: Pain, Ventricular extrasystoles — Feeling: GoodFree text: yes, i received 3rd moderna (which was 1st booster) 11/21/21 then received my 2nd shingrix 11 days later. Very achy after that for few days and subsequently developed frequent premature ventricular contraction (18,000/day) which lastedseveral monthsMedDRA releases: 2024-11 · check-in free text available
- 2022-09-26
- 2022-10-03
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-12-19
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-23 | Moderna | |
| 2 | 2021-01-21 | Moderna | |
| 3 | 2021-11-20 | Moderna | No |
| 4 | 2022-09-19 | Pfizer-BioNTech | No |
Free text
Release 11 — 12 months, dose 2
Symptoms: Covid diagnosis despite booster 11/20/21. Exposed to infected coworker 1/6/21. First symptoms 1/9/21. Positive PCR for covid 1/11/21. Today (1/21) is my 10th day of isolation. Lost smell/taste. Impression Moderna vaccines & booster did not work cut off by CDC
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): yes, i received 3rd moderna (which was 1st booster) 11/21/21 then received my 2nd shingrix 11 days later. Very achy after that for few days and subsequently developed frequent premature ventricular contraction (18,000/day) which lastedseveral months cut off by CDC
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 | Ageusia | · | · | ✓ |
| SD | Anosmia | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Occupational exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Patient isolation | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Ventricular extrasystoles | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release