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52Q-12286-02062

2 vaccinations 4 coded responses 8 check-ins 4 free-text entries 3 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
330 / FL
Registered
2021-02-16
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-19
    Dose 1 — Moderna
  2. 2021-02-16
    Registered in v-safe
  3. 2021-02-16
    Dose 2 — Moderna
  4. 2021-02-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-02-24
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  6. 2021-03-04
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  7. 2021-03-09
    Survey response — day 21, dose 2
    MedDRA: Pruritus — Feeling: Good
    Free text: I have had some itching on my back and side but otherwise Im fine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-18
    Survey response — day 28, dose 2
    MedDRA: Emergency care, Gastric volvulus, Haemoglobin decreased, Hypertension, Pyrexia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization
    Free text: Symptoms: Gastric Volvulus that resulted in an operation to straightened out stomach. Associated with fever and high blood pressure. Low hemoglobin blood count. · Healthcare visit (other): Emergency operations
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-18
    Report sent to call center — day 28, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-03-23
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-04-01
    Survey response — day 42, dose 2
    MedDRA: Emergency care, Gastric volvulus, Surgery — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Symptoms: I had emergency surgery for Gastric Volvulus so I am recovering from that. · Healthcare visit (other): Gastric Volvulus.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-01
    Report sent to call center — day 42, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-05-19
    Survey response — 3 months, dose 2
    MedDRA: Gastric volvulus, Laparoscopic surgery, Surgery — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization
    Free text: Symptoms: I suffered from gastric Volvulus approximately four weeks after second shot. It was corrected by surgery. I have had nothing since then. · Healthcare visit (other): Laparoscopic surgery
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-19
    Report sent to call center — 3 months, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  15. 2021-06-09

Vaccinations

DoseDateManufacturerCo-administered
12021-01-19Moderna
22021-02-16Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 5 — day 21, dose 2

2021-03-09

Symptoms: I have had some itching on my back and side but otherwise Im fine.

Release 5 — day 28, dose 2

2021-03-18

Symptoms: Gastric Volvulus that resulted in an operation to straightened out stomach. Associated with fever and high blood pressure. Low hemoglobin blood count.
Healthcare visit (other): Emergency operations

Release 6 — day 42, dose 2

2021-04-01

Symptoms: I had emergency surgery for Gastric Volvulus so I am recovering from that.
Healthcare visit (other): Gastric Volvulus.

Release 8 — 3 months, dose 2

2021-05-19

Symptoms: I suffered from gastric Volvulus approximately four weeks after second shot. It was corrected by surgery. I have had nothing since then.
Healthcare visit (other): Laparoscopic surgery

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

FieldPreferred term2021-092023-042024-11
HCVOEmergency care ✓ ✓ ✓
HCVOGastric volvulus ✓ ✓ ✓
HCVOLaparoscopic surgery ✓ ✓ ✓
SDEmergency care ✓ ✓ ✓
SDGastric volvulus ✓ ✓ ✓
SDHaemoglobin decreased ✓ ✓ ✓
SDHypertension ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDSurgery ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release