436-59432-74908
5 vaccinations
7 coded responses
41 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 208 / MD
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Dose 1 — Moderna
-
2021-01-30
Registered in v-safe
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2021-02-01
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Pyrexia — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache · Be unable to work, Be unable to do your normal daily activitiesFree text: Yesterday, the third day after the shot, I had severe shivers, chills, and my temperature got up to 101.6.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-02
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-12
- 2021-02-19
- 2021-02-26
-
2021-02-28
Dose 2 — Moderna
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2021-02-28
Health check-in — day 0, dose 2Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Fever · Chills · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Pyrexia — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: I had 102° around 6 PM yesterday. That was after I reported to you yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-04
-
2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-07
- 2021-03-14
- 2021-03-21
- 2021-03-28
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2021-04-04
Survey response — day 35, dose 2MedDRA: Cough — Feeling: GoodFree text: I have an occasional cough.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-11
- 2021-05-30
- 2021-08-31
-
2021-11-03
Dose 3 — Moderna
- 2022-02-28
-
2022-04-10
Dose 4 — Moderna
- 2022-04-29
- 2022-05-01
- 2022-05-08
- 2022-07-10
-
2022-09-22
Dose 5 — Pfizer-BioNTechCo-administered: Flu
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2022-09-23
Survey response — days 1–6 daily, dose 5MedDRA: Somnolence — Feeling: Fair · Fever · Chills, Headache, Fatigue or tirednessFree text: I slept most of today.MedDRA releases: 2024-11 · check-in free text available
- 2022-09-24
- 2022-09-25
- 2022-09-26
- 2022-09-27
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2022-09-28
Survey response — days 1–6 daily, dose 5MedDRA: Unevaluable event — Feeling: GoodFree text: I chose none here, so there should be NO follow up questionMedDRA releases: 2024-11 · check-in free text available
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2022-09-29
Survey response — day 7, dose 5MedDRA: No adverse event — Feeling: GoodFree text: I did not report any symptoms, so the follow up question should not be asked.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-06
- 2022-10-14
- 2022-10-30
- 2022-11-03
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2022-12-23
Survey response — 3 months, dose 5MedDRA: Cough, Office visit, Rhinorrhoea — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Cough, runny nose · Healthcare visit (other): Went to my ENT doctor. You should have an option to check that someone went to see the doctor.MedDRA releases: 2024-11 · check-in free text available
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2022-12-23
Report sent to call center — 3 months, dose 5Get care from a doctor or other healthcare professional1 call case(s)
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2022-12-27
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-03-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Moderna | |
| 2 | 2021-02-28 | Moderna | |
| 3 | 2021-11-03 | Moderna | No |
| 4 | 2022-04-10 | Moderna | No |
| 5 | 2022-09-22 | Pfizer-BioNTech | Flu |
Call center
1 call center case
1 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Yesterday, the third day after the shot, I had severe shivers, chills, and my temperature got up to 101.6.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): I had 102° around 6 PM yesterday. That was after I reported to you yesterday
Release 6 — day 35, dose 2
Symptoms: I have an occasional cough.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): I slept most of today.
Systemic reaction (other): I chose none here, so there should be NO follow up question
Release 12 — day 7, dose 5
Systemic reaction (other): I did not report any symptoms, so the follow up question should not be asked.
Release 12 — 3 months, dose 5
Symptoms: Cough, runny nose
Healthcare visit (other): Went to my ENT doctor. You should have an option to check that someone went to see the doctor.
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Somnolence | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release