62A-30072-03881
5 vaccinations
4 coded responses
53 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 376 / TN
- Registered
- 2021-02-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-16
Dose 1 — Moderna
-
2021-02-17
Registered in v-safe
-
2021-02-17
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
-
2021-03-02
Survey response — day 14, dose 1MedDRA: Office visit, Retinal haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: I developed a new left retinal artery hemorrhage despite BP 110/68 , cholesterol 140, and BMI of 22.3 without medications . I suspect this is due to my COVID -19 illness in December , not the vaccination. · Healthcare visit (other): ophthalmologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-02
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-09
Survey response — day 21, dose 1MedDRA: Retinal haemorrhage, Vitreous floaters — Feeling: FairFree text: Still have left eye floater from recent retinal hemorrhageMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
-
2021-03-19
Dose 2 — Moderna
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-06-18
- 2021-09-17
-
2021-09-20
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-10-27
Dose 3 — Moderna
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fever · Fatigue or tirednessAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2022-01-26
- 2022-04-27
-
2022-05-03
Dose 4 — Moderna
- 2022-05-19
- 2022-05-24
- 2022-05-31
-
2022-06-07
Survey response — day 35, dose 4MedDRA: Fatigue, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: High fever, very sore throat, extreme fatigue ,aching , bedfast for four days . Four daily negative home rapid COVID-19 tests . Practicing CDC guidelines. Today (day 5) marked improvement. Second Moderna booster was 5/03/22. I'm sure this is COVID-1.MedDRA releases: 2024-11 · check-in free text available
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2022-06-14
Survey response — day 42, dose 4MedDRA: Bedridden, Fatigue, Oropharyngeal pain, Paranasal sinus hypersecretion, Pre-existing disease, Pyrexia, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I developed high fever (>102F), fatigue , was bedfast 5 days, thick sinus drainage , terribly sore throat, 30days after my second Moderna booster . This was like my first COVID-19 illness as a doctor in 12/20. This time 5 Rapid tests were negative.MedDRA releases: 2024-11 · check-in free text available
- 2022-08-02
-
2022-09-19
Dose 5 — Moderna
- 2022-09-24
- 2022-09-25
- 2022-09-26
- 2022-10-03
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-12-19
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-16 | Moderna | |
| 2 | 2021-03-19 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-05-03 | Moderna | No |
| 5 | 2022-09-19 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — day 14, dose 1
Symptoms: I developed a new left retinal artery hemorrhage despite BP 110/68 , cholesterol 140, and BMI of 22.3 without medications . I suspect this is due to my COVID -19 illness in December , not the vaccination.
Healthcare visit (other): ophthalmologist
Release 5 — day 21, dose 1
Symptoms: Still have left eye floater from recent retinal hemorrhage
Release 11 — day 35, dose 4
Symptoms: High fever, very sore throat, extreme fatigue ,aching , bedfast for four days . Four daily negative home rapid COVID-19 tests . Practicing CDC guidelines. Today (day 5) marked improvement. Second Moderna booster was 5/03/22. I'm sure this is COVID-1. cut off by CDC
Release 12 — day 42, dose 4
Symptoms: I developed high fever (>102F), fatigue , was bedfast 5 days, thick sinus drainage , terribly sore throat, 30days after my second Moderna booster . This was like my first COVID-19 illness as a doctor in 12/20. This time 5 Rapid tests were negative. cut off by CDC
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 | Bedridden | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Retinal haemorrhage | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vitreous floaters | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release