5RJ-85831-89069
2 vaccinations
3 coded responses
21 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 150 / PA
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-25
Dose 1 — Moderna
-
2021-02-27
Registered in v-safe
-
2021-02-27
Survey response — days 1–6 daily, dose 1MedDRA: Impaired driving ability — Feeling: FairFree text: My ability to drive safely has declined (temporarily, I imagine).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-12
- 2021-03-20
-
2021-03-25
Dose 2 — Moderna
-
2021-03-25
Survey response — day 0, dose 2MedDRA: Myalgia — Feeling: GoodFree text: After the first dose, I experienced muscle pain. I didnt mention it before because it was sporadic and always passed quickly. I didnt experience any of this today, not before the second dose and not after, either.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-10
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
-
2021-09-25
Survey response — 6 months, dose 2MedDRA: Blood test abnormal, Intensive care, Pancytopenia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Pancytopenia related to taking meds apparently that caused allThese bloodLevelsToLower. Was in ICU. StillMay need boneMarrow biopsy. Find out this weekMedDRA releases: 2024-11 · check-in free text available
-
2021-09-25
Report sent to call center — 6 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 prHospitalization · 1 call case(s)
-
2021-09-29
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna | |
| 2 | 2021-03-25 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): My ability to drive safely has declined (temporarily, I imagine).
Release 6 — day 0, dose 2
Systemic reaction (other): After the first dose, I experienced muscle pain. I didnt mention it before because it was sporadic and always passed quickly. I didnt experience any of this today, not before the second dose and not after, either.
Release 9 — 6 months, dose 2
Symptoms: Pancytopenia related to taking meds apparently that caused allThese bloodLevelsToLower. Was in ICU. StillMay need boneMarrow biopsy. Find out this week
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 | Blood test abnormal | · | · | ✓ |
| SD | Intensive care | · | · | ✓ |
| SD | Pancytopenia | · | · | ✓ |
| SRO | Impaired driving ability | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release