6YE-28726-22559
2 vaccinations
5 coded responses
24 check-ins
5 free-text entries
4 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 017 / MA
- Registered
- 2021-02-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-24
Registered in v-safe
-
2021-02-24
Dose 1 — Moderna
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-19
- 2021-03-24
-
2021-03-25
Dose 2 — Moderna
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
-
2021-03-29
Survey response — days 1–6 daily, dose 2MedDRA: Dyspnoea — Feeling: Poor · DiarrheaFree text: Shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-30
-
2021-03-31
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, Abdominal painAdult check-in
- 2021-04-03
-
2021-04-12
Survey response — day 14, dose 2MedDRA: Abdominal cavity drainage, Cardiac disorder, Chronic obstructive pulmonary disease, Hospitalisation, Intra-abdominal fluid collection, Pre-existing disease — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: I have underlying heart condition diabetes COPD and I am in the hospital right now for these things water fluid had to be drained from my stomach but I dont think any of these has to do with the shot I think its just coincidental that it happenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-12
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-15
Survey response — day 21, dose 2MedDRA: Cardiac failure, Hospitalisation, Renal failure — Feeling: Fair · Get care from a doctor or other healthcare professional · HospitalizationFree text: Heart failure kidney failure Ive been in the hospital for over a week I dont know that this has anything to do with the cove it is a long-standing issuesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-15
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-22
-
2021-04-29
Survey response — day 35, dose 2MedDRA: Cough, Dyspnoea, Productive cough — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: CoughPhlegmShort of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-29
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-06
- 2021-06-24
-
2021-09-24
Survey response — 6 months, dose 2MedDRA: COVID-19 — Feeling: Fair · 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 consultationFree text: CovidMedDRA releases: 2024-11 · check-in free text available
-
2021-09-24
Report sent to call center — 6 months, dose 2Be 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)
- 2021-09-27
-
2021-09-29
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-24 | Moderna | |
| 2 | 2021-03-25 | Moderna |
Call center
4 call center cases
4 successful
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Shortness of breath
Release 7 — day 14, dose 2
Symptoms: I have underlying heart condition diabetes COPD and I am in the hospital right now for these things water fluid had to be drained from my stomach but I dont think any of these has to do with the shot I think its just coincidental that it happen
Release 7 — day 21, dose 2
Symptoms: Heart failure kidney failure Ive been in the hospital for over a week I dont know that this has anything to do with the cove it is a long-standing issues
Release 8 — day 35, dose 2
Symptoms: CoughPhlegmShort of breath
Release 9 — 6 months, dose 2
Symptoms: Covid
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 | Abdominal cavity drainage | ✓ | ✓ | ✓ |
| SD | Cardiac disorder | ✓ | ✓ | ✓ |
| SD | Cardiac failure | ✓ | ✓ | ✓ |
| SD | Chronic obstructive pulmonary disease | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Intra-abdominal fluid collection | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Productive cough | ✓ | ✓ | ✓ |
| SD | Renal failure | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release