4WV-10717-89203
2 vaccinations
7 coded responses
17 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 787 / TX
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-25
Dose 1 — Moderna
-
2021-01-26
Registered in v-safe
-
2021-01-26
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-27
Survey response — days 1–6 daily, dose 1MedDRA: Hypersomnia — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to workFree text: Acute sense of smellMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-01-29
- 2021-01-30
-
2021-02-01
Survey response — day 7, dose 1MedDRA: Paraesthesia, Parosmia — Feeling: Fair · Fatigue or tiredness, DiarrheaFree text: Fantom water going down my right leg, and increased sense of smellMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
-
2021-02-15
Survey response — day 21, dose 1MedDRA: Parosmia — Feeling: GoodFree text: Smell ,, everything smells differentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-22
-
2021-02-26
Dose 2 — Moderna
-
2021-03-08
Survey response — day 7, dose 2MedDRA: Respiratory tract congestion — Feeling: Poor · Fatigue or tiredness · Be unable to workFree text: Lung congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-14
Survey response — day 14, dose 2MedDRA: Cold sweat, Cough, Nasopharyngitis, Oropharyngeal pain, Pain, Pulmonary congestion — Feeling: Poor · Be unable to workFree text: Cold symptoms, ache, lung congestion, sore throat, cough. Clamy but no feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-19
Survey response — day 21, dose 2MedDRA: Fatigue — Feeling: PoorFree text: Tired, exhaustedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-28
- 2021-04-04
- 2021-04-11
- 2021-05-31
-
2021-08-27
Survey response — 6 months, dose 2MedDRA: COVID-19, Delirium, Diarrhoea, Fatigue, Hypoaesthesia, Nausea, Productive cough — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Recovering from covid, i have a lingering delirium and an uneasy stomach and diarrhea, hands and feet feeling numb and still holding a mild productive cough, daily routine is more exhausting than i remember.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-27
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
-
2021-09-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | |
| 2 | 2021-02-26 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Acute sense of smell
Release 3 — day 7, dose 1
Systemic reaction (other): Fantom water going down my right leg, and increased sense of smell
Release 4 — day 21, dose 1
Symptoms: Smell ,, everything smells different
Release 5 — day 7, dose 2
Systemic reaction (other): Lung congestion
Release 5 — day 14, dose 2
Symptoms: Cold symptoms, ache, lung congestion, sore throat, cough. Clamy but no fever
Release 5 — day 21, dose 2
Symptoms: Tired, exhausted
Release 9 — 6 months, dose 2
Symptoms: Recovering from covid, i have a lingering delirium and an uneasy stomach and diarrhea, hands and feet feeling numb and still holding a mild productive cough, daily routine is more exhausting than i remember.
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 |
|---|---|---|---|---|
| SD | Cold sweat | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | COVID-19 | ✓ | · | ✓ |
| SD | Delirium | ✓ | · | ✓ |
| SD | Diarrhoea | ✓ | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hypoaesthesia | ✓ | · | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Parosmia | ✓ | ✓ | ✓ |
| SD | Productive cough | ✓ | · | ✓ |
| SD | Pulmonary congestion | ✓ | ✓ | ✓ |
| SRO | Hypersomnia | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Parosmia | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release