45G-83838-61240
4 vaccinations
7 coded responses
29 check-ins
6 free-text entries
5 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 336 / FL
- Registered
- 2021-01-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-04
Registered in v-safe
-
2021-01-04
Dose 1 — Moderna
- 2021-01-04
-
2021-01-05
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-01-06
- 2021-01-07
-
2021-01-08
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Feeling of happiness and relief.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-09
- 2021-01-13
- 2021-01-18
- 2021-01-25
-
2021-02-01
Dose 2 — Moderna
- 2021-02-01
-
2021-02-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
-
2021-03-15
Survey response — day 42, dose 2MedDRA: Fatigue, Gout, Headache, Pre-existing disease, Sneezing — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Headaches, sneezing, fatigue and also a bout of gout.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-05
-
2021-08-03
Survey response — 6 months, dose 2MedDRA: Cough, Fatigue, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Cough, extreme fatigue, sore throat · Healthcare visit (other): CVS rapid COVID test negativeMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-03
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-08-05
- 2021-08-10
-
2021-08-31
Dose 3 — Moderna
- 2021-12-02
-
2022-03-01
Survey response — 6 months, dose 3MedDRA: Hypertension, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: High blood pressure · Healthcare visit (other): Lots of medical visits for cardiac tests.MedDRA releases: 2024-11 · check-in free text available
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2022-03-01
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-03-03
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2022-08-02
Dose 4 — Moderna
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2022-08-31
Survey response — 12 months, dose 3MedDRA: Headache, Oropharyngeal pain, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Unevaluable event, Upper respiratory tract congestion — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Severe sore throat; upper respiratory congestion; headaches daily. 2 COVID negative tests (home and PCR), followed by POSITIVE hone test. Next day got monoclonal antibody infusion and now, 6 days later, 100% well. · Healthcare visit (other): Monoclonal antibody infusion outpatient at hospitalMedDRA releases: 2024-11 · check-in free text available
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2022-08-31
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-09-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-09-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-09-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-09-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-09-06
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2022-11-03
Survey response — 3 months, dose 4MedDRA: Blood pressure inadequately controlled, Hospitalisation — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Out of control blood pressure put in hospital 2 days of tests. All good now. Not COVEID related.MedDRA releases: 2024-11 · check-in free text available
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2022-11-03
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-11-04
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2023-01-31
Survey response — 6 months, dose 4MedDRA: Cough, Ear pain, Epistaxis, Sinus congestion — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-01 | Moderna | |
| 3 | 2021-08-31 | Moderna | No |
| 4 | 2022-08-02 | Moderna | No |
Call center
5 call center cases
4 successful · 1 unsuccessful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Feeling of happiness and relief.
Release 5 — day 42, dose 2
Symptoms: Headaches, sneezing, fatigue and also a bout of gout.
Release 9 — 6 months, dose 2
Symptoms: Cough, extreme fatigue, sore throat
Healthcare visit (other): CVS rapid COVID test negative
Release 11 — 6 months, dose 3
Symptoms: High blood pressure
Healthcare visit (other): Lots of medical visits for cardiac tests.
Release 12 — 12 months, dose 3
Symptoms: Severe sore throat; upper respiratory congestion; headaches daily. 2 COVID negative tests (home and PCR), followed by POSITIVE hone test. Next day got monoclonal antibody infusion and now, 6 days later, 100% well.
Healthcare visit (other): Monoclonal antibody infusion outpatient at hospital
Release 12 — 3 months, dose 4
Symptoms: Out of control blood pressure put in hospital 2 days of tests. All good now. Not COVEID related.
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 | SARS-CoV-2 test negative | ✓ | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Blood pressure inadequately controlled | · | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | Ear pain | · | · | ✓ |
| SD | Epistaxis | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Gout | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SD | Upper respiratory tract congestion | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release