5DQ-61183-41381
3 vaccinations
4 coded responses
26 check-ins
4 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 920 / CA
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
- 2021-01-24
-
2021-01-25
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-27
- 2021-01-29
- 2021-01-30
-
2021-02-07
Survey response — day 14, dose 1MedDRA: Chills, Hypersensitivity — Feeling: GoodFree text: Got chills and allegry symptoms over night. Appear enviroment and work related, Not vaccine related.Temporary.... 12 hrs very uncomfortable, tapering down aprrox 36 hours....MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
-
2021-02-20
Survey response — day 28, dose 1MedDRA: Gastrointestinal disorder, Office visit — Feeling: Good · Be unable to work, 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: Symptoms: Abdominal and chest issues · Healthcare visit (other): Dr Office visit....MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-20
Report sent to call center — day 28, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-01
Survey response — day 35, dose 1MedDRA: Abdominal discomfort, Office visit — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Appatently Unrelated to Covid or vaccine. Upper abdominal issues... as yet undetermined. · Healthcare visit (other): Dr appointment and follow tests up testsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-01
Report sent to call center — day 35, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-06
Dose 2 — Moderna
- 2021-03-06
-
2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-09
- 2021-03-13
- 2021-03-21
- 2021-03-29
- 2021-04-05
- 2021-04-10
- 2021-04-17
- 2021-06-07
- 2021-08-30
- 2021-09-04
-
2021-10-29
Dose 3 — Moderna
- 2021-11-01
-
2021-11-06
Health check-in — day 7, dose 3Feeling: Fair · Vomiting, Diarrhea, Abdominal pain · Be unable to work or attend schoolAdult check-in
-
2021-12-06
Survey response — day 35, dose 3MedDRA: Diarrhoea — Feeling: Good · Be unable to do your normal daily activitiesFree text: Diarrhea..... probably not related. Out of country past month (Mexico)MedDRA releases: 2024-11 · check-in free text available
- 2021-12-11
- 2022-01-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-03-06 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
Call center
2 call center cases
2 unsuccessful
1 wait over 3 months for a first call
Free text
Release 3 — day 14, dose 1
Symptoms: Got chills and allegry symptoms over night. Appear enviroment and work related, Not vaccine related.Temporary.... 12 hrs very uncomfortable, tapering down aprrox 36 hours....
Release 4 — day 28, dose 1
Release 4 — day 35, dose 1
Symptoms: Appatently Unrelated to Covid or vaccine. Upper abdominal issues... as yet undetermined.
Healthcare visit (other): Dr appointment and follow tests up tests
Release 10 — day 35, dose 3
Symptoms: Diarrhea..... probably not related. Out of country past month (Mexico)
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release