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
-
2021-01-08
Dose 1 — Moderna
-
2021-01-21
Registered in v-safe
-
2021-01-22
Survey response — day 14, dose 1MedDRA: Dysphonia — Feeling: FairFree text: Throat hoarseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
-
2021-02-05
Dose 2 — Moderna
- 2021-02-14
- 2021-02-19
- 2021-02-27
-
2021-03-05
Survey response — day 28, dose 2MedDRA: Diarrhoea, Vomiting — Feeling: FairFree text: Vomiting one day and diahrea for the last weekMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Survey response — day 35, dose 2MedDRA: Diarrhoea, SARS-CoV-2 test negative, Vomiting — Feeling: Good · Be unable to do your normal daily activitiesFree text: Vomiting one day and diahrea for about 5 days. Took a Covid test and tested NEGATIVEMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-09
Survey response — 3 months, dose 2MedDRA: Cardiac stress test, Heart rate abnormal — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Heart rate not stable · Healthcare visit (other): Getting an echo and stress testMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-09
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-08-06
Survey response — 6 months, dose 2MedDRA: Anxiety, Gastroenteritis viral, Insomnia, Panic attack, Prostatomegaly, Ulcer haemorrhage — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Bleeding ulcers, enlarged prostate, stomach virus panic attacks and anxiety, unable to sleep two days in a rowMedDRA releases: 2021-09,2024-11 · check-in free text available
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2022-02-05
Survey response — 12 months, dose 2MedDRA: Cough, Productive cough, Prostatomegaly, Unevaluable event — Feeling: FairFree text: Enlarged prostate, needs a urulift. Haven't scheduled an appointment for it. Sinus, phlegm, coughMedDRA releases: 2024-11 · check-in free text available
-
2022-04-10
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-05 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 2 — day 14, dose 1
Symptoms: Throat hoarse
Release 5 — day 28, dose 2
Symptoms: Vomiting one day and diahrea for the last week
Release 5 — day 35, dose 2
Symptoms: Vomiting one day and diahrea for about 5 days. Took a Covid test and tested NEGATIVE
Release 8 — 3 months, dose 2
Symptoms: Heart rate not stable
Healthcare visit (other): Getting an echo and stress test
Release 9 — 6 months, dose 2
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Cardiac stress test | ✓ | ✓ | ✓ |
| SD | Anxiety | ✓ | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dysphonia | ✓ | ✓ | ✓ |
| SD | Gastroenteritis viral | ✓ | · | ✓ |
| SD | Heart rate abnormal | ✓ | ✓ | ✓ |
| SD | Insomnia | ✓ | · | ✓ |
| SD | Panic attack | ✓ | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Prostatomegaly | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Ulcer haemorrhage | ✓ | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release