4ZT-33036-54692
2 vaccinations
7 coded responses
24 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 383 / TN
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-11
Registered in v-safe
-
2021-02-11
Dose 1 — Moderna
- 2021-02-11
-
2021-02-12
Survey response — days 1–6 daily, dose 1MedDRA: Confusional state, Medical counselling, Urinary tract infection — Feeling: Good · Fatigue or tiredness · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Slight confusion · Healthcare visit (other): Home health nurse visited. Was concerned about the confusion and called the doctor for a possible urinary infection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-12
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-13
Survey response — days 1–6 daily, dose 1MedDRA: Confusional state — Feeling: Good · Fatigue or tirednessFree text: Still some slight confusionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-14
Survey response — days 1–6 daily, dose 1MedDRA: Confusional state — Feeling: Good · Fatigue or tirednessFree text: Still a little confusion, but better.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-15
Survey response — days 1–6 daily, dose 1MedDRA: Confusional state — Feeling: Good · Fatigue or tirednessFree text: Confusion is better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-16
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Arthritis — Feeling: Good · Joint painsFree text: I have arthritis and my joint pain is probably due to the extreme cold.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-17
Survey response — days 1–6 daily, dose 1MedDRA: Arthritis, Pre-existing disease — Feeling: Fair · Joint pains, Abdominal painFree text: I have severe arthritis in my feet. They have bothered me today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-18
Survey response — day 7, dose 1MedDRA: Arthritis, Fall — Feeling: Fair · Joint pains, Muscle or body achesFree text: These issues are not related to the coronavirus vaccine. I fell this morning around 3:00 am and my arthritis is bothering me today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-03-04
-
2021-03-12
Dose 2 — Moderna
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-06-11
- 2021-08-02
- 2021-09-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-11 | Moderna | |
| 2 | 2021-03-12 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Slight confusion
Healthcare visit (other): Home health nurse visited. Was concerned about the confusion and called the doctor for a possible urinary infection.
Systemic reaction (other): Still some slight confusion
Systemic reaction (other): Still a little confusion, but better.
Systemic reaction (other): Confusion is better today.
Systemic reaction (other): I have arthritis and my joint pain is probably due to the extreme cold.
Systemic reaction (other): I have severe arthritis in my feet. They have bothered me today.
Release 4 — day 7, dose 1
Systemic reaction (other): These issues are not related to the coronavirus vaccine. I fell this morning around 3:00 am and my arthritis is bothering me today.
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 | Confusional state | ✓ | ✓ | ✓ |
| HCVO | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Urinary tract infection | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Arthritis | ✓ | ✓ | ✓ |
| SRO | Confusional state | ✓ | ✓ | ✓ |
| SRO | Fall | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release