45M-21101-61756
5 vaccinations
6 coded responses
47 check-ins
5 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 856 / AZ
- Registered
- 2021-02-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-09
Registered in v-safe
-
2021-02-09
Dose 1 — Moderna
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
-
2021-03-11
Dose 2 — Moderna
- 2021-03-16
-
2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Fatigue, Pain, Pyrexia — Feeling: GoodFree text: You didnt check with me on the day I got my second shot. The day after I had high fever and chills all day and bodyaches. I had mild fever the day after that. The day after that no fever but I was still a little tired. The day after that I was totally fine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
-
2021-06-10
Survey response — 3 months, dose 2MedDRA: Office visit, Proctalgia — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Proctalgia · Healthcare visit (other): Doctors appointment for examMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-10
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-21
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-09-11
Survey response — 6 months, dose 2MedDRA: Cyst removal — Feeling: Good · Be unable to do your normal daily activitiesFree text: Surgery to remove cystMedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Dose 3 — Moderna
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-02
- 2021-11-03
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2022-01-26
-
2022-04-08
Dose 4 — Moderna
- 2022-04-15
- 2022-04-22
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
-
2022-07-08
Survey response — 3 months, dose 4MedDRA: Fatigue — Feeling: GoodFree text: FatigueMedDRA releases: 2024-11 · check-in free text available
-
2022-09-14
Dose 5 — Moderna
- 2022-10-07
- 2022-10-11
- 2022-10-12
-
2022-10-19
Survey response — day 35, dose 5MedDRA: Dry mouth, Energy increased, Fatigue, Thirst, Weight decreased — Feeling: FairFree text: Had steroid epidural over October 10. After that started losing weight a pound or more a day and thirsty and dry mouth and tons of energy. Now it's like it's wearing off and I'm really tired today. I think it was the steroid, not the vaccineMedDRA releases: 2024-11 · check-in free text available
- 2022-10-26
- 2022-12-14
-
2023-03-15
Survey response — 6 months, dose 5MedDRA: Chills, Influenza virus test negative, Office visit, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-03-15
Report sent to call center — 6 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2023-03-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-09 | Moderna | |
| 2 | 2021-03-11 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-08 | Moderna | No |
| 5 | 2022-09-14 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): You didnt check with me on the day I got my second shot. The day after I had high fever and chills all day and bodyaches. I had mild fever the day after that. The day after that no fever but I was still a little tired. The day after that I was totally fine.
Release 9 — 3 months, dose 2
Release 9 — 6 months, dose 2
Symptoms: Surgery to remove cyst
Release 12 — 3 months, dose 4
Symptoms: Fatigue
Release 12 — day 35, dose 5
Symptoms: Had steroid epidural over October 10. After that started losing weight a pound or more a day and thirsty and dry mouth and tons of energy. Now it's like it's wearing off and I'm really tired today. I think it was the steroid, not the vaccine
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 | Chills | · | · | ✓ |
| SD | Cyst removal | · | · | ✓ |
| SD | Dry mouth | · | · | ✓ |
| SD | Energy increased | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Proctalgia | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Thirst | · | · | ✓ |
| SD | Weight decreased | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release