5MB-23017-83855
5 vaccinations
4 coded responses
60 check-ins
4 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 542 / WI
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-01
Registered in v-safe
-
2021-04-01
Dose 1 — Moderna
- 2021-04-01
-
2021-04-02
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
-
2021-04-03
Survey response — days 1–6 daily, dose 1MedDRA: Pyrexia — Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessFree text: Note: My normal body temp runs low by about 1° F, so a 99° F temperature is a slight fever for me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-22
-
2021-04-29
Dose 2 — Moderna
-
2021-04-29
Health check-in — day 0, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-06-10
- 2021-07-29
- 2021-10-30
-
2021-11-15
Dose 3 — Moderna
- 2021-11-15
-
2021-11-16
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-11-17
- 2021-11-18
- 2021-11-19
- 2021-11-20
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-13
- 2021-12-20
- 2021-12-27
- 2022-02-14
-
2022-04-29
Dose 4 — Moderna
- 2022-04-29
-
2022-04-30
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-01
- 2022-05-02
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-06-10
-
2022-07-31
Survey response — 3 months, dose 4MedDRA: Abdominal pain, Chills, Cough, Haematuria, Headache, Myalgia, Office visit, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Moderate fever, headache, muscle aches, dry cough, minor chills, abdominal pain, blood in urine. Tested negative for Covid 19 three times (2 self-tests, 1 PCR test). · Healthcare visit (other): Primary doctor's office visit with in-house x-ray, blood and urine labs.MedDRA releases: 2024-11 · check-in free text available
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2022-07-31
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-08-01
-
2022-10-14
Dose 5 — ModernaCo-administered: Flu
-
2022-10-28
Survey response — 6 months, dose 4MedDRA: Abdominal discomfort, Office visit, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Unexplained fever and abdominal discomfort for several days. Negative home and PCR tests for COVID. No explanations from lower abdominal and chest CTs or blood work. · Healthcare visit (other): Primary care physician office visit.MedDRA releases: 2024-11 · check-in free text available
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2022-10-28
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-10-30
- 2022-10-31
- 2022-10-31
- 2022-11-04
- 2022-11-11
-
2022-11-18
Survey response — day 35, dose 5MedDRA: Cough, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: FairFree text: Head cold. Minor dry cough. No sore throat or fever. Home COVID antigen test negative.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-25
- 2023-01-13
- 2023-04-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-04-29 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-04-29 | Moderna | No |
| 5 | 2022-10-14 | Moderna | Flu |
Call center
2 call center cases
2 unsuccessful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Note: My normal body temp runs low by about 1° F, so a 99° F temperature is a slight fever for me.
Release 12 — 3 months, dose 4
Symptoms: Moderate fever, headache, muscle aches, dry cough, minor chills, abdominal pain, blood in urine. Tested negative for Covid 19 three times (2 self-tests, 1 PCR test).
Healthcare visit (other): Primary doctor's office visit with in-house x-ray, blood and urine labs.
Release 12 — 6 months, dose 4
Symptoms: Unexplained fever and abdominal discomfort for several days. Negative home and PCR tests for COVID. No explanations from lower abdominal and chest CTs or blood work.
Healthcare visit (other): Primary care physician office visit.
Release 12 — day 35, dose 5
Symptoms: Head cold. Minor dry cough. No sore throat or fever. Home COVID antigen test negative.
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 | Abdominal pain | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Haematuria | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release