6C7-28957-41915

2 vaccinations 7 coded responses 23 check-ins 7 free-text entries 4 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 321 / FL
Registered: 2021-01-02

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-31
Dose 1 — Moderna
2021-01-02
Registered in v-safe
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Pre-existing disease — Feeling: Poor · Site: Pain · Be unable to do your normal daily activities

Free text: Difficult breathing. I have asthma and was having minor problems prior to the vaccination. I recently began an antibiotic treatment. At 1pm took my 1st Cefuroxime 500mg tablet. Script calls for BID for 10 days. Will this affect the Moderna vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: Still on antibiotics and breathing is much better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-01-07
Survey response — day 7, dose 1
MedDRA: Fatigue, Pre-existing disease — Feeling: Fair · Fatigue or tiredness

Free text: Becoming fatigued during light to moderate exertion. But this may be due to existing respiratory issues unrelated to the vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills

Adult check-in
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Elevated Heart Rate 60 normal to 85

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Survey response — day 14, dose 2
MedDRA: Blood pressure systolic increased, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Since the 2nd shot, my systolic BP is up around 20 pts. Doctors have me monitoring 2 or 3 times daily · Healthcare visit (other): In person office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Survey response — 3 months, dose 2
MedDRA: Atrial fibrillation, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: AFIB and Respiratory · Healthcare visit (other): Office visits

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-27
Survey response — 6 months, dose 2
MedDRA: Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Nothing COVID or vaccine related

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-27
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-30
Call 1 — Left Voicemail
2022-01-31
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-26	Moderna

Call center

4 call center cases

2 successful · 1 unsuccessful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-02

Systemic reaction (other): Difficult breathing. I have asthma and was having minor problems prior to the vaccination. I recently began an antibiotic treatment. At 1pm took my 1st Cefuroxime 500mg tablet. Script calls for BID for 10 days. Will this affect the Moderna vaccine

2021-01-03

Systemic reaction (other): Still on antibiotics and breathing is much better

Release 1 — day 7, dose 1

2021-01-07

Systemic reaction (other): Becoming fatigued during light to moderate exertion. But this may be due to existing respiratory issues unrelated to the vaccination

Release 2 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Elevated Heart Rate 60 normal to 85

Release 3 — day 14, dose 2

2021-02-09

Symptoms: Since the 2nd shot, my systolic BP is up around 20 pts. Doctors have me monitoring 2 or 3 times daily

Healthcare visit (other): In person office visit

Release 8 — 3 months, dose 2

2021-04-27

Symptoms: AFIB and Respiratory

Healthcare visit (other): Office visits

Release 9 — 6 months, dose 2

2021-07-27

Symptoms: Nothing COVID or vaccine related

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	Atrial fibrillation	✓	✓	✓
SD	Blood pressure systolic increased	✓	✓	✓
SD	Unevaluable event	✓	·	✓
SRO	Asthma	○	○	○
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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