Z4S-15229-37873
5 vaccinations
8 coded responses
38 check-ins
7 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 144 / NY
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Dose 1 — Moderna
-
2021-01-23
Registered in v-safe
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2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Back injury, Back pain — Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: All lower back pain, probably not from shot. Twisted while pushing snow sideways.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Pain, Unevaluable event — Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Those pains were probably from moving snow sideways a few days agoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Survey response — day 7, dose 1MedDRA: Unevaluable event — Feeling: Good · Muscle or body aches · Be unable to do your normal daily activitiesFree text: Probably a strainMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
- 2021-02-09
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2021-02-16
Dose 2 — Moderna
- 2021-02-16
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2021-02-17
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Fair · Site: Pain · Headache, NauseaFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-17
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2021-09-02
Dose 3 — Moderna
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2021-12-02
Survey response — 3 months, dose 3MedDRA: Asthenia, Fatigue, Hypersomnia, Lyme disease — Feeling: GoodFree text: Very tired. Sleeping 12-15 hrs/day. Took doxycycline for Lyme's Disease but I haven't given blood yet for antibodies. I am sleeping 7-8 hrs again and have energy again, but I don't know if I had Lyme's Disease yet.MedDRA releases: 2024-11 · check-in free text available
- 2022-03-03
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2022-04-02
Dose 4 — Moderna
- 2022-04-14
- 2022-04-18
- 2022-04-23
- 2022-04-30
- 2022-05-07
- 2022-05-14
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2022-07-02
Survey response — 3 months, dose 4MedDRA: Aortic aneurysm repair, Aortic valve replacement, Cardiac operation, Cardiac pacemaker insertion — Feeling: Good · Be unable to do your normal daily activitiesFree text: Open heart surgery, bovine aortic valve, Dacron root, pacemaker. No Covid19MedDRA releases: 2024-11 · check-in free text available
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2022-09-12
Dose 5 — Pfizer-BioNTech
- 2022-09-20
- 2022-09-26
- 2022-10-03
- 2022-10-10
- 2022-10-17
- 2022-10-26
- 2022-12-12
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2023-03-13
Survey response — 6 months, dose 5MedDRA: COVID-19, Dyspnoea exertional, Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-09-02 | Moderna | No |
| 4 | 2022-04-02 | Moderna | No |
| 5 | 2022-09-12 | Pfizer-BioNTech | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): No
Systemic reaction (other): All lower back pain, probably not from shot. Twisted while pushing snow sideways.
Systemic reaction (other): Those pains were probably from moving snow sideways a few days ago
Release 2 — day 7, dose 1
Systemic reaction (other): Probably a strain
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): No
Release 10 — 3 months, dose 3
Symptoms: Very tired. Sleeping 12-15 hrs/day. Took doxycycline for Lyme's Disease but I haven't given blood yet for antibodies. I am sleeping 7-8 hrs again and have energy again, but I don't know if I had Lyme's Disease yet.
Release 12 — 3 months, dose 4
Symptoms: Open heart surgery, bovine aortic valve, Dacron root, pacemaker. No Covid19
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 | Aortic aneurysm repair | · | · | ✓ |
| SD | Aortic valve replacement | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Cardiac operation | · | · | ✓ |
| SD | Cardiac pacemaker insertion | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea exertional | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Hypersomnia | · | · | ✓ |
| SD | Lyme disease | · | · | ✓ |
| SRO | Back injury | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release