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
-
2021-01-19
Dose 1 — Moderna
-
2021-02-16
Registered in v-safe
-
2021-02-16
Dose 2 — Moderna
- 2021-02-19
- 2021-02-24
- 2021-03-04
-
2021-03-09
Survey response — day 21, dose 2MedDRA: Pruritus — Feeling: GoodFree 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
-
2021-03-18
Survey response — day 28, dose 2MedDRA: 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, HospitalizationFree 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 operationsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-18
Report sent to call center — day 28, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-23
-
2021-04-01
Survey response — day 42, dose 2MedDRA: 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 visitFree 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
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2021-04-01
Report sent to call center — day 42, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-05-19
Survey response — 3 months, dose 2MedDRA: 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, HospitalizationFree 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 surgeryMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-19
Report sent to call center — 3 months, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-16 | Moderna |
Call center
3 call center cases
3 unsuccessful
Free text
Release 5 — day 21, dose 2
Symptoms: I have had some itching on my back and side but otherwise Im fine.
Release 5 — day 28, dose 2
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
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Emergency care | ✓ | ✓ | ✓ |
| HCVO | Gastric volvulus | ✓ | ✓ | ✓ |
| HCVO | Laparoscopic surgery | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Gastric volvulus | ✓ | ✓ | ✓ |
| SD | Haemoglobin decreased | ✓ | ✓ | ✓ |
| SD | Hypertension | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Surgery | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release