4Z3-17878-08382
3 vaccinations
6 coded responses
31 check-ins
6 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 31-35
- ZIP prefix
- 410 / KY
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-13
Registered in v-safe
-
2021-01-13
Dose 1 — Moderna
-
2021-01-14
Survey response — days 1–6 daily, dose 1MedDRA: Decreased appetite — Feeling: Good · Site: PainFree text: Diminished appetiteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-22
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Moderna
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
- 2021-08-11
-
2021-10-25
Dose 3 — Moderna
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-11-01
Health check-in — day 7, dose 3Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-11-08
Survey response — day 14, dose 3MedDRA: Chills, Decreased appetite, Disorientation, Dizziness, Headache, Impaired work ability, Mobility decreased, Nausea, Office visit, Pain, Pyrexia — 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 professionalFree text: Symptoms: Fever, nausea, dizziness, disorientation, body aches, body chills, severe headache, loss of appetite, inability to work or do anything but sleep or lay in bed. · Healthcare visit (other): Saw primary care doctor in person, blood workMedDRA releases: 2024-11 · check-in free text available
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2021-11-08
Report sent to call center — day 14, dose 3Be 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)
- 2021-11-10
-
2021-11-15
Survey response — day 21, dose 3MedDRA: Adverse reaction, Office visit — 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 professionalFree text: Symptoms: I have had the same symptoms as my last check in and they are continuing and seeming to be more frequent. · Healthcare visit (other): Primary care doctor visit, FMLA applicationMedDRA releases: 2024-11 · check-in free text available
-
2021-11-15
Report sent to call center — day 21, dose 3Be 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)
- 2021-11-16
- 2021-11-22
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2021-11-29
Survey response — day 35, dose 3MedDRA: Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Same as they have been.MedDRA releases: 2024-11 · check-in free text available
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2021-12-06
Survey response — day 42, dose 3MedDRA: Impaired work ability — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: About to lose my job for a sick days I have had. I understand mistakes happen. But someone needs to help me. Dockers won't see me. PleaseMedDRA releases: 2024-11 · check-in free text available
- 2022-01-24
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2022-04-25
Survey response — 6 months, dose 3MedDRA: Disorientation, Dizziness, Dysstasia, Headache, Nausea, Pain, Pyrexia, Unevaluable event — 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 professionalFree text: Symptoms: Fever, nausea, worsened headache, body pain, Disorientation, dizziness, inability to stand. Why is there not unsure option for the last question? I'm marking yes for unsure. · Healthcare visit (other): I am under house arrest so I am afraid to get medical care.MedDRA releases: 2024-11 · check-in free text available
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2022-04-25
Report sent to call center — 6 months, dose 3Be 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)
- 2022-04-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Call center
3 call center cases
3 unsuccessful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Diminished appetite
Release 10 — day 14, dose 3
Symptoms: Fever, nausea, dizziness, disorientation, body aches, body chills, severe headache, loss of appetite, inability to work or do anything but sleep or lay in bed.
Healthcare visit (other): Saw primary care doctor in person, blood work
Release 10 — day 21, dose 3
Symptoms: I have had the same symptoms as my last check in and they are continuing and seeming to be more frequent.
Healthcare visit (other): Primary care doctor visit, FMLA application
Release 10 — day 35, dose 3
Symptoms: Same as they have been.
Release 10 — day 42, dose 3
Symptoms: About to lose my job for a sick days I have had. I understand mistakes happen. But someone needs to help me. Dockers won't see me. Please
Release 11 — 6 months, dose 3
Symptoms: Fever, nausea, worsened headache, body pain, Disorientation, dizziness, inability to stand. Why is there not unsure option for the last question? I'm marking yes for unsure.
Healthcare visit (other): I am under house arrest so I am afraid to get medical care.
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 | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Adverse reaction | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Disorientation | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Dysstasia | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Impaired work ability | · | · | ✓ |
| SD | Mobility decreased | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release