5FL-32191-16821
2 vaccinations
4 coded responses
16 check-ins
4 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 473 / IN
- Registered
- 2021-02-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Dose 1 — Moderna
-
2021-02-22
Registered in v-safe
-
2021-02-22
Survey response — day 14, dose 1MedDRA: Immunisation reaction — Feeling: GoodFree text: COVID arm reddish circleMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-03-05
-
2021-03-12
Dose 2 — Moderna
- 2021-03-12
-
2021-03-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-03-14
- 2021-03-15
-
2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-17
-
2021-04-02
Survey response — day 21, dose 2MedDRA: Lymphadenopathy, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Lymph node under left arm swollen This is the arm my 2nd dose was Given. Seen my family doctor. · Healthcare visit (other): General appointmentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-02
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-11
- 2021-04-16
-
2021-04-23
Survey response — day 42, dose 2MedDRA: Lymphadenopathy, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Auxiliary lymph nodes under my arms are still swollen. But not painful. · Healthcare visit (other): In office appointment.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-11
- 2021-06-14
- 2021-09-10
-
2022-03-14
Survey response — 12 months, dose 2MedDRA: Biliary catheter insertion, Coronary arterial stent insertion, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Symptoms: November 17 they put a stent in my heart and a drain in my gallbladder today is March 14 and I still have the drain to my gallbladder. · Healthcare visit (other): Currently awaiting gallbladder surgery no date setMedDRA releases: 2024-11 · check-in free text available
-
2022-03-14
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-03-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | |
| 2 | 2021-03-12 | Moderna |
Call center
3 call center cases
3 successful
Free text
Release 4 — day 14, dose 1
Symptoms: COVID arm reddish circle
Release 6 — day 21, dose 2
Symptoms: Lymph node under left arm swollen This is the arm my 2nd dose was Given. Seen my family doctor.
Healthcare visit (other): General appointment
Release 7 — day 42, dose 2
Symptoms: Auxiliary lymph nodes under my arms are still swollen. But not painful.
Healthcare visit (other): In office appointment.
Release 11 — 12 months, dose 2
Symptoms: November 17 they put a stent in my heart and a drain in my gallbladder today is March 14 and I still have the drain to my gallbladder.
Healthcare visit (other): Currently awaiting gallbladder surgery no date set
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 | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Biliary catheter insertion | · | · | ✓ |
| SD | Coronary arterial stent insertion | · | · | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release