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ZPL-52258-45111

2 vaccinations 4 coded responses 15 check-ins 4 free-text entries 2 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
334 / FL
Registered
2021-02-13
Relationship
Self
Race
White
Ethnicity
N/A

Timeline

  1. 2021-02-13
    Registered in v-safe
  2. 2021-02-13
    Dose 1 — Moderna
  3. 2021-02-13
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-02-22
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-03-13
    Dose 2 — Moderna
  6. 2021-03-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Muscle spasms, Vision blurred — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities
    Free text: Leg cramps, blurred vision
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-03-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness
    Adult check-in
  9. 2021-03-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache
    Adult check-in
  10. 2021-03-20
    Health check-in — day 7, dose 2
    Feeling: Fair · Headache
    Adult check-in
  11. 2021-03-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-04-03
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-04-10
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-04-17
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-04-24
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-06-12
    Survey response — 3 months, dose 2
    MedDRA: Abdominal pain upper, Chills, Emergency care, Frequent bowel movements, Hyperhidrosis, Presyncope, Weight decreased — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: I had to go to our emergency room at our primer office i had a lot of pain in my stomic and started to faint and had to get on floor with chills and sweets and a lot of poop i lost 15 lbs then i went for xrays at two places then to the up the heni do
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-06-12
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  18. 2021-06-22
  19. 2021-09-11
    Survey response — 6 months, dose 2
    MedDRA: Office visit, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: I had 4 masve no 2 one last night i have ben to ptimer ergant care two times and to the up they (b)(6) doctor (b)(6)
    MedDRA releases: 2024-11 · check-in free text available
  20. 2021-09-11
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  21. 2021-09-13
  22. 2022-03-15
    Survey response — 12 months, dose 2
    MedDRA: Unevaluable event — Feeling: Fair
    Free text: Went to ear at olvie garden in (b)(6) and had a day and a have of going to the bathroom
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-02-13Moderna
22021-03-13Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-06-12 Unsuccessful
2021-09-11 Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): Leg cramps, blurred vision

Release 9 — 3 months, dose 2

2021-06-12

Symptoms: I had to go to our emergency room at our primer office i had a lot of pain in my stomic and started to faint and had to get on floor with chills and sweets and a lot of poop i lost 15 lbs then i went for xrays at two places then to the up the heni do cut off by CDC

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: I had 4 masve no 2 one last night i have ben to ptimer ergant care two times and to the up they (b)(6) doctor (b)(6)
redacted (b)(6)

Release 11 — 12 months, dose 2

2022-03-15

Symptoms: Went to ear at olvie garden in (b)(6) and had a day and a have of going to the bathroom
redacted (b)(6)

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

FieldPreferred term2021-092023-042024-11
SDAbdominal pain upper ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDEmergency care ✓ ✓ ✓
SDFrequent bowel movements ✓ ✓ ✓
SDHyperhidrosis ✓ ✓ ✓
SDOffice visit · · ✓
SDPresyncope ✓ ✓ ✓
SDUnevaluable event · · ✓
SDWeight decreased ✓ ✓ ✓
SROMuscle spasms ✓ ✓ ✓
SROVision blurred ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release