Z9F-17463-13326
3 vaccinations
4 coded responses
23 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 275 / NC
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Dose 1 — Moderna
-
2021-02-18
Registered in v-safe
-
2021-02-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, Joint pains, Fatigue or tirednessAdult check-in
- 2021-02-19
- 2021-02-20
- 2021-02-27
-
2021-03-07
Survey response — day 21, dose 1MedDRA: Arthralgia — Feeling: GoodFree text: Pain in upper left hip. Seems to be subsiding. Probably unrelated to vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-14
Dose 2 — Moderna
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-28
- 2021-04-04
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2021-04-11
Survey response — day 28, dose 2MedDRA: Chills, Fatigue, Pain, Somnolence — Feeling: GoodFree text: On Tuesday 4/6 I experienced fatigue, chills and mild achiness. I slept most of the day. The next day I was fine.I hope it was a reaction to the vaccine since it would mean it was working, but it was 23 days later.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-18
- 2021-04-25
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2021-06-13
Survey response — 3 months, dose 2MedDRA: Hospitalisation, Sepsis, Urinary tract infection — Feeling: Good · Be unable to do your normal daily activitiesFree text: Urinary tract infection leading to near sepsis and 2 day hospitalization.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-09-12
-
2022-03-14
Survey response — 12 months, dose 2MedDRA: Asthenia, COVID-19, Fatigue, Hospitalisation, Muscular weakness — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Hospitalized with covid on 9/26/21. Discharged 10/1/21. Still experiencing chronic fatigue and weakness especially in the legs.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-21
Dose 3 — Moderna
- 2022-10-20
- 2023-01-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-14 | Moderna | |
| 3 | 2022-07-21 | Moderna | No |
Free text
Release 5 — day 21, dose 1
Symptoms: Pain in upper left hip. Seems to be subsiding. Probably unrelated to vaccination.
Release 7 — day 28, dose 2
Symptoms: On Tuesday 4/6 I experienced fatigue, chills and mild achiness. I slept most of the day. The next day I was fine.I hope it was a reaction to the vaccine since it would mean it was working, but it was 23 days later.
Release 9 — 3 months, dose 2
Symptoms: Urinary tract infection leading to near sepsis and 2 day hospitalization.
Release 11 — 12 months, dose 2
Symptoms: Hospitalized with covid on 9/26/21. Discharged 10/1/21. Still experiencing chronic fatigue and weakness especially in the legs.
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 | Asthenia | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Muscular weakness | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Sepsis | ✓ | ✓ | ✓ |
| SD | Somnolence | ✓ | ✓ | ✓ |
| SD | Urinary tract infection | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release