42M-33877-73083
5 vaccinations
12 coded responses
60 check-ins
12 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 782 / TX
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-22
Dose 1 — Moderna
-
2021-01-30
Registered in v-safe
-
2021-01-30
Survey response — day 7, dose 1MedDRA: Dizziness — Feeling: GoodFree text: Lightheaded the day of the vaccine for 2 hoursMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
-
2021-02-12
Survey response — day 21, dose 1MedDRA: Abdominal discomfort — Feeling: GoodFree text: Upset stomach each night when I go to bed. It only bothers me when lay for bed.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
-
2021-02-27
Dose 2 — Moderna
-
2021-02-27
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · HeadacheAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Abdominal painAdult check-in
-
2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: Pain · DiarrheaFree text: Mild pain around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
- 2021-03-03
- 2021-03-04
-
2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-03-08
-
2021-03-13
Survey response — day 14, dose 2MedDRA: Dizziness, Hypotension — Feeling: Good · Be unable to do your normal daily activitiesFree text: Low blood pressure and lightheadness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-20
Survey response — day 21, dose 2MedDRA: Dizziness — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Dizzness/lightheadiness since yesterday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-29
- 2021-04-03
- 2021-04-10
-
2021-05-29
Survey response — 3 months, dose 2MedDRA: Inflammation, Peripheral swelling — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Right foot swollen and painful due to inflammation.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-29
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-28
-
2021-10-08
Dose 3 — Moderna
-
2021-10-08
Survey response — day 0, dose 3MedDRA: No adverse event — Feeling: Good · Site: Pain · HeadacheFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2021-10-10
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2021-10-11
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-10-12
-
2021-10-15
Survey response — day 7, dose 3MedDRA: No adverse event — Feeling: Good · Fatigue or tirednessFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2021-10-22
Survey response — day 14, dose 3MedDRA: Abdominal discomfort, Diarrhoea — Feeling: GoodFree text: Regular upset stomach and diarrhea.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2022-01-07
- 2022-04-08
-
2022-04-13
Dose 4 — Moderna
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2022-04-13
Health check-in — day 0, dose 4Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body achesAdult check-in
-
2022-04-14
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
- 2022-04-15
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-21
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2022-04-27
Survey response — day 14, dose 4MedDRA: Asthenia, Fatigue — Feeling: Good · Be unable to do your normal daily activitiesFree text: Tireness and low energy level.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-28
- 2022-05-04
- 2022-05-11
- 2022-05-19
- 2022-05-25
- 2022-07-13
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2022-10-12
Survey response — 6 months, dose 4MedDRA: Dyspnoea, Pulmonary oedema — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Shortness of breath episodes and fluid buildup in my lungs.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-12
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-10-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-11-09
Dose 5 — Moderna
- 2022-11-09
-
2022-11-10
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-11-12
- 2022-11-13
- 2022-11-14
- 2022-11-15
- 2022-11-16
- 2022-11-23
- 2022-11-30
- 2022-12-07
- 2022-12-14
- 2022-12-21
- 2023-02-08
- 2023-05-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-27 | Moderna | |
| 3 | 2021-10-08 | Moderna | No |
| 4 | 2022-04-13 | Moderna | No |
| 5 | 2022-11-09 | Moderna | No |
Call center
2 call center cases
2 successful
1 wait over 3 months for a first call
Free text
Release 3 — day 7, dose 1
Systemic reaction (other): Lightheaded the day of the vaccine for 2 hours
Release 4 — day 21, dose 1
Symptoms: Upset stomach each night when I go to bed. It only bothers me when lay for bed.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Mild pain around the injection site
Release 5 — day 14, dose 2
Symptoms: Low blood pressure and lightheadness.
Release 6 — day 21, dose 2
Symptoms: Dizzness/lightheadiness since yesterday.
Release 8 — 3 months, dose 2
Symptoms: Right foot swollen and painful due to inflammation.
Release 10 — day 0, dose 3
Systemic reaction (other): No
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): No
Release 10 — day 7, dose 3
Systemic reaction (other): No
Release 10 — day 14, dose 3
Symptoms: Regular upset stomach and diarrhea.
Release 11 — day 14, dose 4
Symptoms: Tireness and low energy level.
Release 12 — 6 months, dose 4
Symptoms: Shortness of breath episodes and fluid buildup in my lungs.
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 discomfort | ✓ | ✓ | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Hypotension | ✓ | ✓ | ✓ |
| SD | Inflammation | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Pulmonary oedema | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release