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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

  1. 2021-02-05
    Dose 1 — Moderna
  2. 2021-02-22
    Registered in v-safe
  3. 2021-02-22
    Survey response — day 14, dose 1
    MedDRA: Immunisation reaction — Feeling: Good
    Free text: COVID arm reddish circle
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-26
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-03-05
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-03-12
    Dose 2 — Moderna
  7. 2021-03-12
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  8. 2021-03-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea
    Adult check-in
  9. 2021-03-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  10. 2021-03-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Diarrhea
    Adult check-in
  11. 2021-03-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  12. 2021-03-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-04-02
    Survey response — day 21, dose 2
    MedDRA: Lymphadenopathy, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    Free 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 appointment
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-02
    Report sent to call center — day 21, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  15. 2021-04-11
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-04-16
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-04-23
    Survey response — day 42, dose 2
    MedDRA: Lymphadenopathy, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free 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
  18. 2021-04-23
    Report sent to call center — day 42, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  19. 2021-06-11
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-06-14
  21. 2021-09-10
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2022-03-14
    Survey response — 12 months, dose 2
    MedDRA: 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, Hospitalization
    Free 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 set
    MedDRA releases: 2024-11 · check-in free text available
  23. 2022-03-14
    Report sent to call center — 12 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
  24. 2022-03-16
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-02-05Moderna
22021-03-12Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-22

Symptoms: COVID arm reddish circle

Release 6 — day 21, dose 2

2021-04-02

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

2021-04-23

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

2022-03-14

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ ✓ ✓
HCVOUnevaluable event · · ✓
SDBiliary catheter insertion · · ✓
SDCoronary arterial stent insertion · · ✓
SDImmunisation reaction ✓ ✓ ✓
SDLymphadenopathy ✓ ✓ ✓
SDOffice visit ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release