4SM-92634-98410
5 vaccinations
11 coded responses
54 check-ins
11 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 681 / NE
- Registered
- 2021-02-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-24
Registered in v-safe
-
2021-02-24
Dose 1 — Moderna
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2021-02-24
Survey response — day 0, dose 1MedDRA: Hypersensitivity — Feeling: Good · Site: Swelling · Muscle or body achesFree text: Had an allergic reaction at the pharmacy. Ill bring my inhaler next dose.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
-
2021-02-26
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Fatigue or tirednessFree text: I have a question I need answered.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-27
Survey response — days 1–6 daily, dose 1MedDRA: Back pain, Mobility decreased, Renal pain — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activitiesFree text: Pain in back/kidneys interfering with mobility.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
-
2021-03-17
Survey response — day 21, dose 1MedDRA: Arthralgia, Myalgia, Pain — Feeling: FairFree text: Feeling achy and sore muscles. Im having unusual trouble with my left knee, like gout or something.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-23
Dose 2 — Moderna
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2021-03-23
Health check-in — day 0, dose 2Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-04-06
-
2021-04-13
Survey response — day 21, dose 2MedDRA: Muscular weakness — Feeling: FairFree text: Muscular weakness on one side.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-20
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2021-04-27
Survey response — day 35, dose 2MedDRA: Cardiac stress test abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Failed a cardiac stress test.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-27
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-05-04
Survey response — day 42, dose 2MedDRA: Office visit, Oxygen consumption decreased, Oxygen saturation decreased — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: O2 levels drop after moderate aerobic exercise (87). · Healthcare visit (other): Cardiologist.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-04
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-22
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2021-09-22
Survey response — 6 months, dose 2MedDRA: Exercise tolerance decreased, Office visit, Patient isolation, Pre-existing disease, Pulmonary function test decreased — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Working with pulmonologist due to diagnosed 50% breathing capacity. Havent had COVID, but the isolation had bad effects on my fitness level and aerobic capacity. · Healthcare visit (other): In person visit in office.MedDRA releases: 2024-11 · check-in free text available
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2021-09-22
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-23
- 2021-09-30
-
2021-09-30
Call successfulDoes not wish to fill out VAERS report
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2021-10-25
Dose 3 — Moderna
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
-
2021-11-08
Survey response — day 14, dose 3MedDRA: Fatigue, Wheezing — Feeling: FairFree text: More wheeziness and tiredness.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-04
Dose 4 — Moderna
- 2022-04-18
- 2022-04-25
- 2022-05-02
-
2022-05-09
Survey response — day 35, dose 4MedDRA: Pre-existing disease — Feeling: FairFree text: AllergiesMedDRA releases: 2024-11 · check-in free text available
- 2022-05-16
- 2022-07-04
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2022-09-27
Dose 5 — Pfizer-BioNTechCo-administered: Flu
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2022-09-30
Survey response — days 1–6 daily, dose 5MedDRA: Insomnia — Feeling: Good · Site: ItchingFree text: Trouble sleepingMedDRA releases: 2024-11 · check-in free text available
- 2022-10-01
- 2022-10-02
- 2022-10-03
- 2022-10-04
- 2022-10-12
- 2022-10-19
- 2022-10-25
- 2022-11-01
- 2022-11-08
- 2022-12-27
- 2023-03-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-24 | Moderna | |
| 2 | 2021-03-23 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-04 | Moderna | No |
| 5 | 2022-09-27 | Pfizer-BioNTech | Flu |
Call center
3 call center cases
3 successful
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): Had an allergic reaction at the pharmacy. Ill bring my inhaler next dose.
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): I have a question I need answered.
Systemic reaction (other): Pain in back/kidneys interfering with mobility.
Release 5 — day 21, dose 1
Symptoms: Feeling achy and sore muscles. Im having unusual trouble with my left knee, like gout or something.
Release 7 — day 21, dose 2
Symptoms: Muscular weakness on one side.
Release 8 — day 35, dose 2
Symptoms: Failed a cardiac stress test.
Release 8 — day 42, dose 2
Symptoms: O2 levels drop after moderate aerobic exercise (87).
Healthcare visit (other): Cardiologist.
Release 9 — 6 months, dose 2
Symptoms: Working with pulmonologist due to diagnosed 50% breathing capacity. Havent had COVID, but the isolation had bad effects on my fitness level and aerobic capacity.
Healthcare visit (other): In person visit in office.
Release 10 — day 14, dose 3
Symptoms: More wheeziness and tiredness.
Release 11 — day 35, dose 4
Symptoms: Allergies
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Trouble sleeping
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Cardiac stress test abnormal | ✓ | ✓ | ✓ |
| SD | Exercise tolerance decreased | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Muscular weakness | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oxygen consumption decreased | ✓ | ✓ | ○ |
| SD | Oxygen saturation decreased | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Patient isolation | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pulmonary function test decreased | · | · | ✓ |
| SD | Wheezing | · | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Mobility decreased | ✓ | ✓ | ✓ |
| SRO | Renal pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release