5BT-30501-96569
4 vaccinations
3 coded responses
40 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 329 / FL
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Moderna
- 2021-02-13
- 2021-02-14
- 2021-02-15
-
2021-02-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-17
- 2021-02-19
- 2021-02-20
- 2021-03-01
- 2021-03-06
-
2021-03-13
Dose 2 — Moderna
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-06-12
-
2021-09-11
Survey response — 6 months, dose 2MedDRA: Bladder calculus removal, Nephrolithiasis, Prostatic disorder, Renal disorder, Stent placement — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: issue with kidneys, had stints put in, prostate shaved a bit, stones removed from bladder, still have small stone in one kidney.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-11
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-11-12
Dose 3 — Moderna
-
2021-12-21
Survey response — day 35, dose 3MedDRA: Bladder calculus removal, Bladder catheterisation, Catheter removal, Renal artery stent placement, Renal stone removal, Transurethral prostatectomy — Feeling: GoodFree text: July 13th had bilateral stints in kidney, t.u.r.p of the prostate and stones removed from bladder. Kidney stones removed on November 8th and foley catheter and one out my back. Foley catheter removed November 12th Back catheter removed November 19thMedDRA releases: 2024-11 · check-in free text available
- 2021-12-26
-
2022-02-12
Survey response — 3 months, dose 3MedDRA: Cough, Fatigue, SARS-CoV-2 test, Sneezing — Feeling: GoodFree text: Not sure when I last checked in, but in early January had a bad sneezing, coughing and very tired spell. Few days later went to the V.A. to be tested for covid-19.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-13
-
2022-05-25
Dose 4 — Moderna
- 2022-05-26
- 2022-05-27
- 2022-05-29
- 2022-05-31
- 2022-06-01
- 2022-06-08
- 2022-06-15
- 2022-06-22
- 2022-06-29
- 2022-07-06
- 2022-08-24
- 2022-11-23
- 2023-05-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-13 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
| 4 | 2022-05-25 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 9 — 6 months, dose 2
Symptoms: issue with kidneys, had stints put in, prostate shaved a bit, stones removed from bladder, still have small stone in one kidney.
Release 10 — day 35, dose 3
Symptoms: July 13th had bilateral stints in kidney, t.u.r.p of the prostate and stones removed from bladder. Kidney stones removed on November 8th and foley catheter and one out my back. Foley catheter removed November 12th Back catheter removed November 19th cut off by CDC
Release 11 — 3 months, dose 3
Symptoms: Not sure when I last checked in, but in early January had a bad sneezing, coughing and very tired spell. Few days later went to the V.A. to be tested for covid-19.
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 | Bladder calculus removal | · | · | ✓ |
| SD | Bladder catheterisation | · | · | ✓ |
| SD | Catheter removal | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Nephrolithiasis | · | · | ✓ |
| SD | Prostatic disorder | · | · | ✓ |
| SD | Renal artery stent placement | · | · | ✓ |
| SD | Renal disorder | · | · | ✓ |
| SD | Renal stone removal | · | · | ✓ |
| SD | SARS-CoV-2 test | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Stent placement | · | · | ✓ |
| SD | Transurethral prostatectomy | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release