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4AJ-29591-28229

2 vaccinations 4 coded responses 22 check-ins 4 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
347 / FL
Registered
2021-03-09
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-08
    Dose 1 — Moderna
  2. 2021-03-09
    Registered in v-safe
  3. 2021-03-09
    Survey response — days 1–6 daily, dose 1
    MedDRA: Heart rate increased — Feeling: Good
    Free text: Elevated pulse for two hours. 82 instead of normal 65.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-03-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-15
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-22
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-29
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-04-12
    Survey response — day 35, dose 1
    MedDRA: Hospitalisation — Feeling: Good
    Free text: Hospitalized two weeks ago with non-Covid related problem. Getting my second Moderna shot Thursday evening.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-04-15
    Dose 2 — Moderna
  14. 2021-04-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-04-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-04-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  17. 2021-04-22
    Survey response — day 7, dose 2
    MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Most of the fatigue has dissipated, getting back to normal.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-29
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-05-06
    Survey response — day 21, dose 2
    MedDRA: Asthenia, Chills, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization
    Free text: Monday night fever and violent shivering. Total loss of energy since. This is the third time since my first shot. Spent four days in hospital late March. Two more events since my second shot May 17.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-05-06
    Report sent to call center — day 21, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  21. 2021-05-13
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-21
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-27
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-07-15
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-10-14
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2022-01-05
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  27. 2022-04-15
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-08Moderna
22021-04-15Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Elevated pulse for two hours. 82 instead of normal 65.

Release 7 — day 35, dose 1

2021-04-12

Symptoms: Hospitalized two weeks ago with non-Covid related problem. Getting my second Moderna shot Thursday evening.

Release 7 — day 7, dose 2

2021-04-22

Systemic reaction (other): Most of the fatigue has dissipated, getting back to normal.

Release 8 — day 21, dose 2

2021-05-06

Symptoms: Monday night fever and violent shivering. Total loss of energy since. This is the third time since my first shot. Spent four days in hospital late March. Two more events since my second shot May 17.

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

FieldPreferred term2021-092023-042024-11
SDAsthenia ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDHospitalisation ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHeart rate increased ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release