56K-22101-19829
5 vaccinations
15 coded responses
66 check-ins
14 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 773 / TX
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Registered in v-safe
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2021-01-11
Dose 1 — Moderna
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2021-01-11
Health check-in — day 0, dose 1Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
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2021-01-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessAdult check-in
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-27
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2021-02-01
Survey response — day 21, dose 1MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: GoodFree text: Mild sniffles, congestion. Nothing else.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
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2021-02-09
Dose 2 — Moderna
- 2021-02-09
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2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesFree text: Hurting from fall on iceMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-23
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2021-03-02
Survey response — day 21, dose 2MedDRA: Abdominal pain — Feeling: FairFree text: Abdominal pain (GI tract or kidneystone??)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
- 2021-03-16
- 2021-03-23
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2021-05-11
Survey response — 3 months, dose 2MedDRA: Fatigue, Respiratory tract congestion — Feeling: GoodFree text: Mild congestion. Occasional fatigue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-10
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2021-10-26
Dose 3 — Moderna
- 2021-10-26
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2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body achesAdult check-in
- 2021-10-29
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-09
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2021-11-16
Survey response — day 21, dose 3MedDRA: Asthenia, Fatigue, Headache, Lethargy, Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea, Sinus congestion — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Head cold with congestion. Fatigue, lethargic, runny, stuffy sinuses. Slight headaches, NO fever or loss of taste. Slight weakness.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2022-04-26
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2022-07-09
Dose 4 — Moderna
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2022-07-11
Survey response — days 1–6 daily, dose 4MedDRA: Blood glucose increased, Fatigue, Feeling abnormal, Malaise, Pyrexia — Feeling: Good · Site: PainFree text: I was very fatigued & felt poorly on July 10th. Slight fever felt unwell. AM blood sugar spiked well above normal for me on July 11.MedDRA releases: 2024-11 · check-in free text available
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2022-07-12
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2022-07-13
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: I underwent an EMG nerve test today; after effects contribute to fatiqueMedDRA releases: 2024-11 · check-in free text available
- 2022-07-14
- 2022-07-15
- 2022-07-16
- 2022-07-23
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2022-07-30
Survey response — day 21, dose 4MedDRA: Ear congestion, Fatigue — Feeling: FairFree text: Ear congestion. Fatigue. Possible exposure to non-COVID bacterial infection from visiting relatives, all of whom have had recent negative COVID test results.MedDRA releases: 2024-11 · check-in free text available
- 2022-08-06
- 2022-08-13
- 2022-08-20
- 2022-10-08
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2022-11-25
Dose 5 — Moderna
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2022-11-26
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-11-27
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-11-28
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-11-29
Survey response — days 1–6 daily, dose 5MedDRA: Blood glucose increased — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Much higher fasting blood sugar readings every morning since booster vaccination.MedDRA releases: 2024-11 · check-in free text available
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2022-11-30
Survey response — days 1–6 daily, dose 5MedDRA: Blood glucose increased — Feeling: Good · Site: PainFree text: Continued unusually high blood glucose readings.MedDRA releases: 2024-11 · check-in free text available
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2022-12-01
Survey response — days 1–6 daily, dose 5MedDRA: Blood glucose increased — Feeling: GoodFree text: Continued hidg blood glucose readings both after fasting & after mealsMedDRA releases: 2024-11 · check-in free text available
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2022-12-02
Survey response — day 7, dose 5MedDRA: Blood glucose increased — Feeling: Good · Site: PainFree text: High blood sugar readings continue.MedDRA releases: 2024-11 · check-in free text available
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2022-12-09
Survey response — day 14, dose 5MedDRA: Coccydynia, Fall, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Experienced fall from chair 5 days ago resulting in moderate pain at bottom of spine. NOT related to Covid vaccination or infection. · Healthcare visit (other): Scheduled appt w/sports medicine specialist; waiting 1 week for earliest available appt.MedDRA releases: 2024-11 · check-in free text available
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2022-12-09
Report sent to call center — day 14, dose 5Get care from a doctor or other healthcare professional1 call case(s)
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2022-12-13
Call successfulNot applicable - Accidental Reporting
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2022-12-16
Survey response — day 21, dose 5MedDRA: Cough, Fatigue, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Be unable to work or attend schoolFree text: Cough. Sore throat. Sniffles. Run downMedDRA releases: 2024-11 · check-in free text available
- 2022-12-23
- 2022-12-31
- 2023-01-06
- 2023-02-27
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2023-05-28
Survey response — 6 months, dose 5MedDRA: Nasopharyngitis, Pre-existing disease — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-09 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-07-09 | Moderna | No |
| 5 | 2022-11-25 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 3 — day 21, dose 1
Symptoms: Mild sniffles, congestion. Nothing else.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Hurting from fall on ice
Release 4 — day 21, dose 2
Symptoms: Abdominal pain (GI tract or kidneystone??)
Release 8 — 3 months, dose 2
Symptoms: Mild congestion. Occasional fatigue.
Release 10 — day 21, dose 3
Symptoms: Head cold with congestion. Fatigue, lethargic, runny, stuffy sinuses. Slight headaches, NO fever or loss of taste. Slight weakness.
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): I was very fatigued & felt poorly on July 10th. Slight fever felt unwell. AM blood sugar spiked well above normal for me on July 11.
Systemic reaction (other): I underwent an EMG nerve test today; after effects contribute to fatique
Release 12 — day 21, dose 4
Symptoms: Ear congestion. Fatigue. Possible exposure to non-COVID bacterial infection from visiting relatives, all of whom have had recent negative COVID test results.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Much higher fasting blood sugar readings every morning since booster vaccination.
Systemic reaction (other): Continued unusually high blood glucose readings.
Systemic reaction (other): Continued hidg blood glucose readings both after fasting & after meals
Release 12 — day 7, dose 5
Systemic reaction (other): High blood sugar readings continue.
Release 12 — day 14, dose 5
Symptoms: Experienced fall from chair 5 days ago resulting in moderate pain at bottom of spine. NOT related to Covid vaccination or infection.
Healthcare visit (other): Scheduled appt w/sports medicine specialist; waiting 1 week for earliest available appt.
Release 12 — day 21, dose 5
Symptoms: Cough. Sore throat. Sniffles. Run down
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 | Unevaluable event | · | · | ✓ |
| SD | Abdominal pain | ✓ | ✓ | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Coccydynia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Ear congestion | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Lethargy | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SRO | Blood glucose increased | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Feeling abnormal | · | · | ✓ |
| SRO | Malaise | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release