593-17663-26014
5 vaccinations
6 coded responses
40 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 773 / TX
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Moderna
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-28
- 2021-02-04
-
2021-02-11
Dose 2 — Moderna
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-20
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-27
- 2021-05-15
- 2021-08-12
-
2021-10-16
Dose 3 — Moderna
- 2021-10-25
-
2021-10-30
Survey response — day 14, dose 3MedDRA: Cough, Dyspnoea, Respiratory tract congestion — Feeling: PoorFree text: Trouble breathing shortness of breath severe congestion in my chest severe cough no feverMedDRA releases: 2024-11 · check-in free text available
-
2021-11-08
Survey response — day 21, dose 3MedDRA: Dyspnoea, Emergency care, Pneumonia, Respiratory tract congestion — Feeling: PoorFree text: Shortness of breath severe congestion in my chest Ben to emergency room three times in the last 2 weeks they tell me it's pneumonia had it since October 17th not getting any betterMedDRA releases: 2024-11 · check-in free text available
- 2021-11-15
-
2021-11-23
Survey response — day 35, dose 3MedDRA: Hospitalisation, Pneumonia, Respiratory disorder — Feeling: PoorFree text: I am in the hospital with pneumonia having severe breathing problemsMedDRA releases: 2024-11 · check-in free text available
- 2021-11-27
- 2022-01-15
-
2022-02-07
Dose 4 — Moderna
- 2022-05-09
- 2022-08-08
-
2022-09-13
Dose 5 — ModernaCo-administered: Pneumonia
- 2022-10-01
- 2022-10-04
- 2022-10-11
- 2022-10-19
-
2022-10-25
Survey response — day 42, dose 5MedDRA: Haematochezia — Feeling: GoodFree text: I have a considerable amount of blood in my stool that has never happened before should have diagnosis soonMedDRA releases: 2024-11 · check-in free text available
-
2022-12-15
Survey response — 3 months, dose 5MedDRA: Asthenia, Atrioventricular block, Fatigue — Feeling: PoorFree text: Have no strength tired all time just found out have some kind of blockage in my heart will know tomorrow exactly what it isMedDRA releases: 2024-11 · check-in free text available
-
2023-03-14
Survey response — 6 months, dose 5MedDRA: Arterial occlusive disease, Fatigue — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2021-10-16 | Moderna | No |
| 4 | 2022-02-07 | Moderna | No |
| 5 | 2022-09-13 | Moderna | Pneumonia |
Free text
Release 10 — day 14, dose 3
Symptoms: Trouble breathing shortness of breath severe congestion in my chest severe cough no fever
Release 10 — day 21, dose 3
Symptoms: Shortness of breath severe congestion in my chest Ben to emergency room three times in the last 2 weeks they tell me it's pneumonia had it since October 17th not getting any better
Release 10 — day 35, dose 3
Symptoms: I am in the hospital with pneumonia having severe breathing problems
Release 12 — day 42, dose 5
Symptoms: I have a considerable amount of blood in my stool that has never happened before should have diagnosis soon
Release 12 — 3 months, dose 5
Symptoms: Have no strength tired all time just found out have some kind of blockage in my heart will know tomorrow exactly what it is
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 |
|---|---|---|---|---|
| SD | Arterial occlusive disease | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Atrioventricular block | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Haematochezia | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release