5VQ-64976-01137
3 vaccinations
5 coded responses
27 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 777 / TX
- Registered
- 2021-02-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Dose 1 — Moderna
-
2021-02-14
Registered in v-safe
-
2021-02-14
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-02-15
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-27
- 2021-03-06
- 2021-03-13
-
2021-03-14
Dose 2 — Moderna
- 2021-03-21
- 2021-03-28
-
2021-04-04
Survey response — day 21, dose 2MedDRA: Arthralgia, Back pain, Neck pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Extremely sore in neck, rear upper right shoulder, and extreme right lower back above natural waistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-11
Survey response — day 28, dose 2MedDRA: Arthralgia, Back pain, Office visit, Pre-existing disease, Surgery — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Having severe pain in rt. Back region just above the waist. Pain in Rt. knee near patella near where Quad Rupture Surgery was performed by (b)(6) team. Kidney change from CLD Stage 3 to CKD Stage 4 · Healthcare visit (other): Inpatient Appt. Next week with Nephrologist, Dr. (b)(6)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-11
Report sent to call center — day 28, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-18
- 2021-04-25
- 2021-06-13
- 2021-09-12
-
2021-10-22
Dose 3 — Moderna
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
-
2021-10-29
Survey response — day 7, dose 3MedDRA: Musculoskeletal stiffness — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: Stiff neckMedDRA releases: 2024-11 · check-in free text available
- 2021-11-05
- 2021-11-12
- 2021-11-21
- 2021-11-27
- 2021-12-03
-
2022-01-21
Survey response — 3 months, dose 3MedDRA: Fatigue, Neck pain — Feeling: FairFree text: Tiredness and sore neckMedDRA releases: 2024-11 · check-in free text available
- 2022-04-01
-
2022-04-26
Survey response — 6 months, dose 3MedDRA: Dizziness, Fatigue, Neck pain — Feeling: FairFree text: Sore Neck, a little dizzy, tiredMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-14 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 6 — day 21, dose 2
Symptoms: Extremely sore in neck, rear upper right shoulder, and extreme right lower back above natural waist
Release 7 — day 28, dose 2
Symptoms: Having severe pain in rt. Back region just above the waist. Pain in Rt. knee near patella near where Quad Rupture Surgery was performed by (b)(6) team. Kidney change from CLD Stage 3 to CKD Stage 4
Healthcare visit (other): Inpatient Appt. Next week with Nephrologist, Dr. (b)(6)
redacted (b)(6)
Release 10 — day 7, dose 3
Systemic reaction (other): Stiff neck
Release 11 — 3 months, dose 3
Symptoms: Tiredness and sore neck
Release 11 — 6 months, dose 3
Symptoms: Sore Neck, a little dizzy, tired
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Surgery | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release