XZ3-35213-14144
3 vaccinations
6 coded responses
34 check-ins
6 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 049 / ME
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Dose 1 — Moderna
-
2021-01-26
Registered in v-safe
- 2021-01-26
- 2021-01-27
-
2021-01-28
Survey response — days 1–6 daily, dose 1MedDRA: Constipation — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-29
- 2021-01-31
- 2021-02-02
- 2021-02-08
- 2021-02-16
-
2021-02-22
Dose 2 — Moderna
- 2021-02-22
-
2021-02-23
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-03
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-04-05
-
2021-05-25
Survey response — 3 month, dose 2MedDRA: Cholecystitis infective, Nephrolithiasis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-25
Report sent to call center — 3 month, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-23
Survey response — 6 month, dose 2MedDRA: Gallbladder operation, Nephrolithiasis, Renal surgery — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationMedDRA releases: 2021-09,2024-11 · check-in answers available
-
2021-08-23
Report sent to call center — 6 month, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-08-25
-
2021-10-23
Dose 3 — Moderna
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
-
2021-11-01
Survey response — 7 day, dose 3MedDRA: Oropharyngeal pain, Upper-airway cough syndrome — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-29
- 2021-12-04
- 2022-01-23
-
2022-04-24
Survey response — 6 month, dose 3MedDRA: Ear congestion, Fatigue, Pain, Rhinorrhoea, SARS-CoV-2 test positive — Feeling: FairMedDRA releases: 2024-11 · check-in answers available
-
2022-10-23
Survey response — 12 month, dose 3MedDRA: COVID-19, Fatigue, Retinal detachment, Retinopexy, Rhinorrhoea, Squamous cell carcinoma of skin — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | |
| 2 | 2021-02-22 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-25 | Unsuccessful | |
| 2021-08-23 | Unsuccessful |
Free text
Release 3
Systemic reaction (other): Constipation X 3 days, now resolved.
Release 8
Symptoms: Infected gall bladder and renal calculi.
Release 9
Symptoms: Gall bladder surgery and kidney stone surgery (laser) in late May.
Release 10
Systemic reaction (other): Sore throat & heavy post nasal drainage post vaccination x 7 days now resolved.
Release 11
Symptoms: Positive covid IHealth test on 4/17/22. Mild noticeable fatigue, running nose (clear), sore, stuffy right ear. NO fever, NO cough, NO shortness of breath.
Release 12
Symptoms: Detached retina/w surgery. Squamous cell skin cancer. Covid positive April 2022 ( mild, runny nose, fatigue, no tx required.
Free-text releases are not linked to a specific 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 | Cholecystitis infective | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ear congestion | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gallbladder operation | ✓ | · | ✓ |
| SD | Nephrolithiasis | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Renal surgery | ✓ | · | ✓ |
| SD | Retinal detachment | · | · | ✓ |
| SD | Retinopexy | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Squamous cell carcinoma of skin | · | · | ✓ |
| SRO | Constipation | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Upper-airway cough syndrome | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release