4ZC-21551-45151
5 vaccinations
12 coded responses
47 check-ins
12 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 014 / MA
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Dose 1 — Moderna
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2021-01-22
Registered in v-safe
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2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Anxiety, Malaise, Pain in extremity — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Some of above, but except some real arm pain for 3 days and some general malaise, I believe the other symptoms are sadly due to current anxiety anti-COVID-19, anti-mask, anti-vaccine roommate which hopefully is almost done on 2/1. I have worked many years with Dr. Fauci on HIV vaccines and more tangentally with Dr. Walenski and many others, so I am just living in a very anxiety-ridden place and hope done on 2/1. To be honest, also, anxiety too that I missed your first two surveys where I had a lot more arm pain, but do not regret vaccine. Thank You.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
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2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Good · DiarrheaFree text: May have been the chipolte burrito.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-27
Survey response — days 1–6 daily, dose 1MedDRA: Malaise — Feeling: Good · NauseaFree text: Just a general malaise since vaccination, but most likely related to a difficult living situation with an anti-vax roommate that will change on 2/1 and other life stressors. All vaccine dose #1 issues have been mild, to date, and very grateful for vaccine. I continue, and will always, basic public health measures of mask, distance, and hand washing measures. Thank You.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-28
Survey response — day 7, dose 1MedDRA: Unevaluable event — Feeling: Good · Fatigue or tirednessFree text: I attribute this to my very anti-COVID19, anti-mask, anti-vaccine roommate and I am moving this Sunday. I am very grateful for the vaccine and I plan on doing a lot of vaccine service work after my 2/18/2021 Moderna 2nd booster shot. Thank you so very much.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
- 2021-02-11
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2021-02-18
Dose 2 — Moderna
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2021-02-18
Survey response — day 0, dose 2MedDRA: Malaise — Feeling: Good · Site: Pain · NauseaFree text: Very mild general malaise, short-lived thus far, and not of any real concern.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-02-20
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
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2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Cough, Stress — Feeling: Good · Fatigue or tirednessFree text: Strange cough that seems to have subsided within 12 hours and probably due to cold weather and a lot of life stressors. I'm not toi concerned and not convinced related at all to vaccine. PS: (b)(6) site is amazing and really now very efficient. Thank You.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Cough, Depression — Feeling: Good · Fatigue or tirednessFree text: Mild cough and some depression, but a lot of life stressors so doubt related to vaccine. Thank You.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-23
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2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Anxiety, Depression, Pre-existing disease, Telemedicine, Vaccine positive rechallenge — Feeling: Good · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Systemic reaction (other): I did have one bout after 1st dose and two bouts after 2nd dose of rather severe acute depression. It was not something I have had in years and I got through it. I did not think it could be vaccine-related, but I just learned that depression and anxiety is a listed long-term sequelae with PASC or long-term conditions amongst some people who were actually infected with COVID-19/SARS-CoV-2. Ergo, I thought that it is worth a mention. Thank You. · Healthcare visit (other): I managed to work through it, but it was strange. I also had my routine telehealth appointments with my psychiatrist and my psychologist which helped a lot. I do not regret getting the vaccine. Thank You.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-24
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-05-20
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2021-08-19
Survey response — 6 months, dose 2MedDRA: Depression, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesFree text: Just more bouts of exacerbated or deeper and more frequent bouts of depression for which I am prone. Seems more often post-vaccine, but I doubt necessarily related and I do not have any regrets about getting the vaccine. I have a great psych team. TxMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-10-28
Dose 3 — ModernaCo-administered: Flu
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
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2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Depression — Feeling: Good · Headache, Fatigue or tirednessFree text: Some depression, but not as intense as after first two doses. Still glad to be vaccinated and no regrets thus far.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-04
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2021-12-05
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-09
- 2022-01-28
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2022-04-02
Dose 4 — Moderna
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2022-04-19
Survey response — day 14, dose 4MedDRA: Pain in extremity — Feeling: GoodFree text: Some arm pain after second booster, but nothing more than expected and not particularly bothersome.MedDRA releases: 2024-11 · check-in free text available
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2022-04-23
Survey response — day 21, dose 4MedDRA: Pain in extremity — Feeling: GoodFree text: Only arm pain that passed post-first Glaxosmith Shingrix inj 50mcg vaccine dose Lot # (b)(6) on 4/20/2022.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-07-02
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2022-09-11
Dose 5 — ModernaCo-administered: Flu
- 2022-09-28
- 2022-10-09
- 2022-10-18
- 2022-10-23
- 2022-12-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-18 | Moderna | |
| 3 | 2021-10-28 | Moderna | Flu |
| 4 | 2022-04-02 | Moderna | No |
| 5 | 2022-09-11 | Moderna | Flu |
Call center
1 call center case
1 successful
1 wait over 3 months for a first call
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Some of above, but except some real arm pain for 3 days and some general malaise, I believe the other symptoms are sadly due to current anxiety anti-COVID-19, anti-mask, anti-vaccine roommate which hopefully is almost done on 2/1. I have worked many years with Dr. Fauci on HIV vaccines and more tangentally with Dr. Walenski and many others, so I am just living in a very anxiety-ridden place and hope done on 2/1. To be honest, also, anxiety too that I missed your first two surveys where I had a lot more arm pain, but do not regret vaccine. Thank You.
Systemic reaction (other): May have been the chipolte burrito.
Systemic reaction (other): Just a general malaise since vaccination, but most likely related to a difficult living situation with an anti-vax roommate that will change on 2/1 and other life stressors. All vaccine dose #1 issues have been mild, to date, and very grateful for vaccine. I continue, and will always, basic public health measures of mask, distance, and hand washing measures. Thank You.
Release 3 — day 7, dose 1
Systemic reaction (other): I attribute this to my very anti-COVID19, anti-mask, anti-vaccine roommate and I am moving this Sunday. I am very grateful for the vaccine and I plan on doing a lot of vaccine service work after my 2/18/2021 Moderna 2nd booster shot. Thank you so very much.
Release 4 — day 0, dose 2
Systemic reaction (other): Very mild general malaise, short-lived thus far, and not of any real concern.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Strange cough that seems to have subsided within 12 hours and probably due to cold weather and a lot of life stressors. I'm not toi concerned and not convinced related at all to vaccine. PS: (b)(6) site is amazing and really now very efficient. Thank You.
redacted (b)(6)
Systemic reaction (other): Mild cough and some depression, but a lot of life stressors so doubt related to vaccine. Thank You.
Systemic reaction (other): I did have one bout after 1st dose and two bouts after 2nd dose of rather severe acute depression. It was not something I have had in years and I got through it. I did not think it could be vaccine-related, but I just learned that depression and anxiety is a listed long-term sequelae with PASC or long-term conditions amongst some people who were actually infected with COVID-19/SARS-CoV-2. Ergo, I thought that it is worth a mention. Thank You.
Healthcare visit (other): I managed to work through it, but it was strange. I also had my routine telehealth appointments with my psychiatrist and my psychologist which helped a lot. I do not regret getting the vaccine. Thank You.
Release 9 — 6 months, dose 2
Symptoms: Just more bouts of exacerbated or deeper and more frequent bouts of depression for which I am prone. Seems more often post-vaccine, but I doubt necessarily related and I do not have any regrets about getting the vaccine. I have a great psych team. Tx cut off by CDC
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Some depression, but not as intense as after first two doses. Still glad to be vaccinated and no regrets thus far.
Release 11 — day 14, dose 4
Symptoms: Some arm pain after second booster, but nothing more than expected and not particularly bothersome.
Release 11 — day 21, dose 4
Symptoms: Only arm pain that passed post-first Glaxosmith Shingrix inj 50mcg vaccine dose Lot # (b)(6) on 4/20/2022.
redacted (b)(6)
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 | Telemedicine | ✓ | ✓ | ✓ |
| SD | Depression | ✓ | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Depression | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Stress | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release