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5UD-92601-22444

2 vaccinations 6 coded responses 10 check-ins 6 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
783 / TX
Registered
2021-01-21
Relationship
Self
Race
White
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-01-08
    Dose 1 — Moderna
  2. 2021-01-21
    Registered in v-safe
  3. 2021-01-22
    Survey response — day 14, dose 1
    MedDRA: Dysphonia — Feeling: Fair
    Free text: Throat hoarse
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-29
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-02-05
    Dose 2 — Moderna
  6. 2021-02-14
    Health check-in — day 7, dose 2
    Feeling: Fair · Site: Itching · None
    Adult check-in
  7. 2021-02-19
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  8. 2021-02-27
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-03-05
    Survey response — day 28, dose 2
    MedDRA: Diarrhoea, Vomiting — Feeling: Fair
    Free text: Vomiting one day and diahrea for the last week
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-12
    Survey response — day 35, dose 2
    MedDRA: Diarrhoea, SARS-CoV-2 test negative, Vomiting — Feeling: Good · Be unable to do your normal daily activities
    Free text: Vomiting one day and diahrea for about 5 days. Took a Covid test and tested NEGATIVE
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-05-09
    Survey response — 3 months, dose 2
    MedDRA: Cardiac stress test, Heart rate abnormal — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Heart rate not stable · Healthcare visit (other): Getting an echo and stress test
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-09
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-08-06
    Survey response — 6 months, dose 2
    MedDRA: Anxiety, Gastroenteritis viral, Insomnia, Panic attack, Prostatomegaly, Ulcer haemorrhage — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Bleeding ulcers, enlarged prostate, stomach virus panic attacks and anxiety, unable to sleep two days in a row
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  14. 2022-02-05
    Survey response — 12 months, dose 2
    MedDRA: Cough, Productive cough, Prostatomegaly, Unevaluable event — Feeling: Fair
    Free text: Enlarged prostate, needs a urulift. Haven't scheduled an appointment for it. Sinus, phlegm, cough
    MedDRA releases: 2024-11 · check-in free text available
  15. 2022-04-10
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-01-08Moderna
22021-02-05Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Throat hoarse

Release 5 — day 28, dose 2

2021-03-05

Symptoms: Vomiting one day and diahrea for the last week

Release 5 — day 35, dose 2

2021-03-12

Symptoms: Vomiting one day and diahrea for about 5 days. Took a Covid test and tested NEGATIVE

Release 8 — 3 months, dose 2

2021-05-09

Symptoms: Heart rate not stable
Healthcare visit (other): Getting an echo and stress test

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: Bleeding ulcers, enlarged prostate, stomach virus panic attacks and anxiety, unable to sleep two days in a row

Release 11 — 12 months, dose 2

2022-02-05

Symptoms: Enlarged prostate, needs a urulift. Haven't scheduled an appointment for it. Sinus, phlegm, cough

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
HCVOCardiac stress test ✓ ✓ ✓
SDAnxiety ✓ · ✓
SDCough · · ✓
SDDiarrhoea ✓ ✓ ✓
SDDysphonia ✓ ✓ ✓
SDGastroenteritis viral ✓ · ✓
SDHeart rate abnormal ✓ ✓ ✓
SDInsomnia ✓ · ✓
SDPanic attack ✓ · ✓
SDProductive cough · · ✓
SDProstatomegaly ✓ · ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓
SDUlcer haemorrhage ✓ · ✓
SDUnevaluable event · · ✓
SDVomiting ✓ ✓ ✓

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