4F7-30097-02366
2 vaccinations
5 coded responses
15 check-ins
5 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 125 / NY
- Registered
- 2021-05-08
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-22
Dose 1 — Moderna
-
2021-05-08
Registered in v-safe
- 2021-05-08
- 2021-05-13
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2021-05-20
Dose 2 — Moderna
-
2021-05-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-05-24
-
2021-05-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-27
Health check-in — day 7, dose 2Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-06-03
Survey response — day 14, dose 2MedDRA: Pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Pain and other symptoms · Healthcare visit (other): Tests ordered by my primary doctor and will see my orinary dictir this coming Monday fir the resultsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-03
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-11
- 2021-06-19
- 2021-06-25
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2021-07-02
Survey response — day 42, dose 2MedDRA: Pollakiuria — Feeling: FairFree text: Not urinating as often as I was the last few days. Watching it and may try to see a doctor next few days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-20
Survey response — 3 months, dose 2MedDRA: Pain, Weight decreased — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Unexplained weight loss, pains etcMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-20
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-02
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2021-11-20
Survey response — 6 months, dose 2MedDRA: Dyspnoea, Inflammation, Pain, Weight decreased — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Pain in various places. Shortness of breath. Weight loss. Frequent inflamations.MedDRA releases: 2024-11 · check-in free text available
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2021-11-20
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-23
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2022-05-23
Survey response — 12 months, dose 2MedDRA: Lethargy, Oropharyngeal pain, Rhinorrhoea, Sneezing — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sore throat, sneezing, constant runny nose, feeling of lethargy, only want to stay in bed.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-22 | Moderna | |
| 2 | 2021-05-20 | Moderna |
Call center
3 call center cases
3 unsuccessful
Free text
Release 8 — day 14, dose 2
Symptoms: Pain and other symptoms
Healthcare visit (other): Tests ordered by my primary doctor and will see my orinary dictir this coming Monday fir the results
Release 9 — day 42, dose 2
Symptoms: Not urinating as often as I was the last few days. Watching it and may try to see a doctor next few days.
Release 9 — 3 months, dose 2
Symptoms: Unexplained weight loss, pains etc
Release 10 — 6 months, dose 2
Symptoms: Pain in various places. Shortness of breath. Weight loss. Frequent inflamations.
Release 11 — 12 months, dose 2
Symptoms: Sore throat, sneezing, constant runny nose, feeling of lethargy, only want to stay in bed.
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Inflammation | · | · | ✓ |
| SD | Lethargy | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pollakiuria | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Weight decreased | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release