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
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Moderna
- 2021-02-13
- 2021-02-22
-
2021-03-13
Dose 2 — Moderna
-
2021-03-16
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree text: Leg cramps, blurred visionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Chills, Headache, Fatigue or tirednessAdult check-in
- 2021-03-19
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-04-24
-
2021-06-12
Survey response — 3 months, dose 2MedDRA: 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 visitFree 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 doMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-12
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-22
-
2021-09-11
Survey response — 6 months, dose 2MedDRA: 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 visitFree 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
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2021-09-11
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-13
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2022-03-15
Survey response — 12 months, dose 2MedDRA: Unevaluable event — Feeling: FairFree text: Went to ear at olvie garden in (b)(6) and had a day and a have of going to the bathroomMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-13 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-12 | Unsuccessful | |
| 2021-09-11 | Unsuccessful |
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Leg cramps, blurred vision
Release 9 — 3 months, dose 2
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
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Frequent bowel movements | ✓ | ✓ | ✓ |
| SD | Hyperhidrosis | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Presyncope | ✓ | ✓ | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Weight decreased | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Vision blurred | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release