6Q8-30873-87997
4 vaccinations
6 coded responses
35 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 498 / MI
- Registered
- 2021-01-09
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-09
Registered in v-safe
-
2021-01-09
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · Site: Pain, Itching · HeadacheFree text: slight headache last night. part of today. gone nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-22
- 2021-01-29
- 2021-02-05
-
2021-02-08
Dose 2 — Moderna
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-22
- 2021-08-09
-
2021-11-10
Dose 3 — Moderna
-
2021-11-11
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fever · Chills, Joint pains, Muscle or body achesAdult check-in
- 2021-11-12
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-16
- 2021-11-17
- 2021-11-24
-
2021-12-01
Survey response — day 21, dose 3MedDRA: Arthralgia, Respiratory tract congestion, Rhinorrhoea — Feeling: FairFree text: stuffy runny nose some joint achedMedDRA releases: 2024-11 · check-in free text available
- 2021-12-08
-
2021-12-15
Survey response — day 35, dose 3MedDRA: Fatigue, Muscle spasms, Rhinorrhoea — Feeling: FairFree text: runny nose. a little fatigue. some muscle cramps in legs. nothing serious thoMedDRA releases: 2024-11 · check-in free text available
-
2021-12-22
Survey response — day 42, dose 3MedDRA: Nasal congestion, Night sweats — Feeling: FairFree text: sweat at night. nasal congestion.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-09
Survey response — 3 months, dose 3MedDRA: Body temperature increased, Cough, Sneezing — Feeling: FairFree text: sneezing. cough. elevated temp by 1 degMedDRA releases: 2024-11 · check-in free text available
-
2022-05-06
Dose 4 — Moderna
- 2022-05-11
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-06-10
-
2022-06-17
Survey response — day 42, dose 4MedDRA: Emergency care, Hospitalisation, Hyperhidrosis, Loss of consciousness, Regurgitation — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: 6/14/23 passed out while playing cribbage and sitting at a table. out for less than a minute. regurgitated, sweated profusely. after 10 mins i was back to normal. visited e r 6/15/22. overnight in hospMedDRA releases: 2024-11 · check-in free text available
-
2022-06-17
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-06-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-11-10 | Moderna | No |
| 4 | 2022-05-06 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): slight headache last night. part of today. gone now
Release 10 — day 21, dose 3
Symptoms: stuffy runny nose some joint ached
Release 10 — day 35, dose 3
Symptoms: runny nose. a little fatigue. some muscle cramps in legs. nothing serious tho
Release 10 — day 42, dose 3
Symptoms: sweat at night. nasal congestion.
Release 11 — 3 months, dose 3
Symptoms: sneezing. cough. elevated temp by 1 deg
Release 12 — day 42, dose 4
Symptoms: 6/14/23 passed out while playing cribbage and sitting at a table. out for less than a minute. regurgitated, sweated profusely. after 10 mins i was back to normal. visited e r 6/15/22. overnight in hosp
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 | Arthralgia | · | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Hyperhidrosis | · | · | ✓ |
| SD | Loss of consciousness | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Night sweats | · | · | ✓ |
| SD | Regurgitation | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release