XZB-11379-85912
5 vaccinations
5 coded responses
54 check-ins
4 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 499 / MI
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-13
Registered in v-safe
-
2021-01-13
Dose 1 — Moderna
- 2021-01-13
- 2021-01-15
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Moderna
- 2021-02-10
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Good · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Good · Fever · Chills, Muscle or body aches, DiarrheaMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
-
2021-02-24
Survey response — 14 day, dose 2MedDRA: Oral herpes — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-04
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
- 2021-08-11
-
2021-10-28
Dose 3 — Pfizer-BioNTech
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2022-01-27
-
2022-03-30
Dose 4 — Moderna
- 2022-04-19
- 2022-04-20
- 2022-04-28
- 2022-05-04
- 2022-05-13
- 2022-06-29
-
2022-09-17
Dose 5 — ModernaCo-administered: Flu
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-23
- 2022-09-24
- 2022-10-01
- 2022-10-08
- 2022-10-15
- 2022-10-22
- 2022-10-29
-
2022-12-17
Survey response — 3 month, dose 5MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-12-17
Report sent to call center — 3 month, dose 5Get care from a doctor or other healthcare professional1 call case(s)
- 2022-12-19
-
2023-03-18
Survey response — 6 month, dose 5MedDRA: Fall, Head injury, Medical counselling, Muscle strain — Feeling: Fair · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2023-03-18
Report sent to call center — 6 month, dose 5Get care from a doctor or other healthcare professional1 call case(s)
- 2023-03-20
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-10-28 | Pfizer-BioNTech | No |
| 4 | 2022-03-30 | Moderna | No |
| 5 | 2022-09-17 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-17 | Unsuccessful | |
| 2023-03-18 | Unsuccessful |
Free text
Release 4
Systemic reaction (other): The above were only last night except the headache persists.
Systemic reaction (other): Symptoms all last night. Feel fine today.
Symptoms: Probably totally unrelated... But I have a persistent cold sort on my upper lip. In the winters I am prone to develop cold sores,, and if it persists I check in with my GP who then prescribes an antiviral and the situation clears.
Release 12
Symptoms: I have issues with a benign, enlarged prostate. Scheduled for corrective surgery next week. I am also 78; I see no linkage to my five COVID shots. My first COVID shot was 3/20. And my urological issues have gotten markedly worse since.
Healthcare visit (other): Urological specialist at (b)(6)Clinic
redacted (b)(6)
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 |
|---|---|---|---|---|
| HCVO | Fall | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Head injury | · | · | ✓ |
| SD | Muscle strain | · | · | ✓ |
| SD | Oral herpes | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release