6NZ-14695-01580
4 vaccinations
6 coded responses
45 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 949 / CA
- Registered
- 2021-04-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-12
Dose 1 — Moderna
-
2021-04-09
Registered in v-safe
-
2021-04-09
Dose 2 — Moderna
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
-
2021-04-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-04-15
- 2021-04-16
- 2021-04-25
-
2021-04-30
Survey response — day 21, dose 2MedDRA: Fatigue, Feeling of body temperature change, Lethargy, Nausea, Pain, Rash — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: After 1st shot 2 weeks later broke out with rash on left butt cheek,felt nausia,lethargic, hot&cold spells, body aches & tired.This lasted 5 days.Rash disappeared.2nd on April 9th,Tuesday 27th rash returned, body aches bad all day,hot&cold, temperatuMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-07-09
-
2021-09-01
Dose 3 — Moderna
- 2021-09-01
-
2021-09-02
Survey response — days 1–6 daily, dose 3MedDRA: Rash — Feeling: Good · Site: Pain, Redness, Swelling · HeadacheFree text: Rash did appear 2 weeks post shot on butt check with prior vaccinationsMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-09-03
- 2021-09-04
-
2021-09-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-09-06
-
2021-09-07
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-09-08
- 2021-09-15
- 2021-09-22
-
2021-09-29
Survey response — day 28, dose 3MedDRA: Chills, Dizziness, Feeling of body temperature change, Sluggishness — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Just sluggish & a little light headed, hot & cold chillsMedDRA releases: 2024-11 · check-in free text available
- 2021-10-06
- 2021-10-13
- 2021-12-01
- 2022-03-02
-
2022-04-14
Dose 4 — Moderna
- 2022-04-14
-
2022-04-15
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2022-04-16
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
-
2022-04-28
Survey response — day 14, dose 4MedDRA: Feeling abnormal, Nausea — Feeling: GoodFree text: Felt off all day & nauseousMedDRA releases: 2024-11 · check-in free text available
- 2022-05-05
- 2022-05-12
-
2022-05-19
Survey response — day 35, dose 4MedDRA: Dizziness, Fatigue, Feeling abnormal, Productive cough, Secretion discharge — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Hit a wall and have been out of it for the last four days, coughing&mucus, light headed.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-26
- 2022-07-14
- 2022-10-13
-
2023-04-14
Survey response — 12 months, dose 4MedDRA: COVID-19, Cough — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-04-14
Report sent to call center — 12 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-04-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna | |
| 2 | 2021-04-09 | Moderna | |
| 3 | 2021-09-01 | Moderna | No |
| 4 | 2022-04-14 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 8 — day 21, dose 2
Symptoms: After 1st shot 2 weeks later broke out with rash on left butt cheek,felt nausia,lethargic, hot&cold spells, body aches & tired.This lasted 5 days.Rash disappeared.2nd on April 9th,Tuesday 27th rash returned, body aches bad all day,hot&cold, temperatu cut off by CDC
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Rash did appear 2 weeks post shot on butt check with prior vaccinations
Release 9 — day 28, dose 3
Symptoms: Just sluggish & a little light headed, hot & cold chills
Release 11 — day 14, dose 4
Symptoms: Felt off all day & nauseous
Release 11 — day 35, dose 4
Symptoms: Hit a wall and have been out of it for the last four days, coughing&mucus, light headed.
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 |
|---|---|---|---|---|
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | · | · | ✓ |
| SD | Feeling of body temperature change | ✓ | ✓ | ✓ |
| SD | Lethargy | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Secretion discharge | · | · | ✓ |
| SD | Sluggishness | · | · | ✓ |
| SRO | Rash | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release