6BF-50072-80732
5 vaccinations
4 coded responses
29 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 201 / VA
- Registered
- 2021-03-01
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-28
Dose 1 — Moderna
-
2021-03-01
Registered in v-safe
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
-
2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Asthenia, Oral herpes — Feeling: Fair · Muscle or body achesFree text: Feeling weak and have cold soreMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-14
- 2021-03-21
-
2021-03-28
Dose 2 — Moderna
- 2021-04-04
- 2021-04-11
- 2021-04-18
- 2021-04-25
-
2021-05-02
Survey response — day 35, dose 2MedDRA: Diarrhoea, Nasal congestion, Sneezing — Feeling: FairFree text: Kind of light diarrhea, nose block and sneezing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-09
- 2021-06-27
-
2021-09-26
Survey response — 6 months, dose 2MedDRA: Cough, Insomnia, Office visit, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Coughing day and night couldn't sleep at night, till I visit a doctor get x-ray for my chest is clear, after two weeks I still coughing, getting nervous so I make an appointment at CVS to do covid-19 test but is negative, now I am recover fully. · Healthcare visit (other): Private doctor visit.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-26
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-30
-
2021-09-30
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-11-11
Dose 3 — Moderna
- 2022-03-28
-
2022-04-06
Dose 4 — ModernaCo-administered: Shingles
- 2022-05-03
- 2022-05-04
- 2022-05-16
- 2022-05-18
- 2022-07-06
-
2022-09-19
Dose 5 — Moderna
- 2022-10-05
- 2022-10-17
-
2022-10-24
Survey response — day 35, dose 5MedDRA: Flatulence, Pain — Feeling: FairFree text: Body pain, comes and go. A lot of gas, when the gas passes then the pain subside.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-31
- 2022-12-21
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-28 | Moderna | |
| 2 | 2021-03-28 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
| 4 | 2022-04-06 | Moderna | Shingles |
| 5 | 2022-09-19 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Feeling weak and have cold sore
Release 8 — day 35, dose 2
Symptoms: Kind of light diarrhea, nose block and sneezing.
Release 9 — 6 months, dose 2
Symptoms: Coughing day and night couldn't sleep at night, till I visit a doctor get x-ray for my chest is clear, after two weeks I still coughing, getting nervous so I make an appointment at CVS to do covid-19 test but is negative, now I am recover fully.
Healthcare visit (other): Private doctor visit.
Release 12 — day 35, dose 5
Symptoms: Body pain, comes and go. A lot of gas, when the gas passes then the pain subside.
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 | Cough | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Flatulence | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Oral herpes | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release