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4PJ-10624-24434

4 vaccinations 3 coded responses 16 check-ins 3 free-text entries 2 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
804 / CO
Registered
2021-03-29
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-22
    Dose 1 — Moderna
  2. 2021-02-19
    Dose 2 — Moderna
  3. 2021-03-29
    Registered in v-safe
  4. 2021-03-29
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  5. 2021-04-02
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  6. 2021-05-23
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  7. 2021-08-20
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  8. 2021-11-24
    Dose 3 — Moderna
  9. 2022-02-19
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in
  10. 2022-02-23
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  11. 2022-05-25
    Dose 4 — Moderna
  12. 2022-05-27
    Survey response — 6 months, dose 3
    MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Prostrate problems were exacerbated since COVID delta late November 2021. Could be attributed to taking theraflu.
    MedDRA releases: 2024-11 · check-in free text available
  13. 2022-05-27
    Report sent to call center — 6 months, dose 3
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  14. 2022-05-29
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Joint pains, Muscle or body aches
    Adult check-in
  15. 2022-05-30
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  16. 2022-05-31
  17. 2022-06-01
    Survey response — day 7, dose 4
    MedDRA: Asthenia, COVID-19, Fatigue, Pre-existing disease — Feeling: Fair · Fatigue or tiredness
    Free text: The fatigue and tiredness are normal. I am 76 yo with a number of pre-existing health difficulties. And did not regain strength after Delta Covid episode end of October 2021.
    MedDRA releases: 2024-11 · check-in free text available
  18. 2022-06-08
    Health check-in — day 14, dose 4
    Feeling: Fair
    Adult check-in
  19. 2022-06-15
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  20. 2022-07-06
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  21. 2022-08-25
    Health check-in — 3 months, dose 4
    Feeling: Fair
    Adult check-in
  22. 2022-11-23
    Survey response — 6 months, dose 4
    MedDRA: Bacterial infection, Endotracheal intubation, Feeding tube user, Hospitalisation, Intensive care, Respiratory failure, Respiratory syncytial virus infection, Sepsis — Feeling: Poor · Be unable to work or attend school, 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: Respiratory failure and sepsis on 11/19. RSV virus and bacterial infection. Still in ICU on breathing and feeding tubes.
    MedDRA releases: 2024-11 · check-in free text available
  23. 2022-11-23
    Report sent to call center — 6 months, dose 4
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Emergency room or emergency department visit · Hospitalization · 1 call case(s)
  24. 2022-11-25
  25. 2022-11-25
  26. 2023-05-25
    Health check-in — 12 months, dose 4
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-22Moderna
22021-02-19Moderna
32021-11-24Moderna No
42022-05-25Moderna No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 11 — 6 months, dose 3

2022-05-27

Symptoms: Prostrate problems were exacerbated since COVID delta late November 2021. Could be attributed to taking theraflu.

Release 11 — day 7, dose 4

2022-06-01

Systemic reaction (other): The fatigue and tiredness are normal. I am 76 yo with a number of pre-existing health difficulties. And did not regain strength after Delta Covid episode end of October 2021.

Release 12 — 6 months, dose 4

2022-11-23

Symptoms: Respiratory failure and sepsis on 11/19. RSV virus and bacterial infection. Still in ICU on breathing and feeding tubes.

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
SDBacterial infection · · ✓
SDCondition aggravated · · ✓
SDEndotracheal intubation · · ✓
SDFeeding tube user · · ✓
SDHospitalisation · · ✓
SDIntensive care · · ✓
SDPre-existing disease · · ✓
SDRespiratory failure · · ✓
SDRespiratory syncytial virus infection · · ✓
SDSepsis · · ✓
SROAsthenia · · ✓
SROCOVID-19 · · ✓
SROFatigue · · ✓
SROPre-existing disease · · ✓

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