59J-31646-80791
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 388 / MS
- Registered
- 2021-03-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Registered in v-safe
-
2021-03-03
Dose 1 — Moderna
-
2021-03-03
Survey response — day 0, dose 1MedDRA: No adverse event — Feeling: Fair · DiarrheaFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
-
2021-04-01
Dose 2 — Moderna
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
- 2021-04-03
- 2021-04-04
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: International normalised ratio decreased, International normalised ratio increased — Feeling: Fair · Fatigue or tirednessFree text: I keep my INR in the 2-3 range, Friday it tested 3.2......very thin.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
-
2021-04-07
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Myalgia, Unevaluable event — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Systemic reaction (other): Felt much better on Monday the 5th, some tiredness and muscle pain. · Healthcare visit (other): Appointment 7AM tomorrow after fasting tonight for blood tests and exam.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
-
2021-07-01
Survey response — 3 months, dose 2MedDRA: International normalised ratio decreased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: My blood INR continues to be MUCH thinner, over 3.0 since taking the 2nd injection.....my blood INR is checked every 2 weeks as prescribed by my Primary MD.I previously reported this condition without an acknowledgement from CDC.....please advise.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-01
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-09
- 2021-07-09
-
2021-10-02
Survey response — 6 months, dose 2MedDRA: Cough, Headache, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sore throat, cough and headacheMedDRA releases: 2024-11 · check-in free text available
-
2021-10-02
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-10-05
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-04-01 | Moderna |
Call center
3 call center cases
1 successful · 2 unsuccessful
1 wait over 3 months for a first call
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): No
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): I keep my INR in the 2-3 range, Friday it tested 3.2......very thin.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Felt much better on Monday the 5th, some tiredness and muscle pain.
Healthcare visit (other): Appointment 7AM tomorrow after fasting tonight for blood tests and exam.
Release 9 — 3 months, dose 2
Symptoms: My blood INR continues to be MUCH thinner, over 3.0 since taking the 2nd injection.....my blood INR is checked every 2 weeks as prescribed by my Primary MD.I previously reported this condition without an acknowledgement from CDC.....please advise.
Release 9 — 6 months, dose 2
Symptoms: Sore throat, cough and headache
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 | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | International normalised ratio decreased | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | International normalised ratio decreased | ○ | ✓ | ○ |
| SRO | International normalised ratio increased | ✓ | · | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release