ZTU-31988-08153
2 vaccinations
4 coded responses
24 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 786 / TX
- Registered
- 2021-01-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-30
Dose 1 — Moderna
-
2021-01-31
Registered in v-safe
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
-
2021-02-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-02-05
- 2021-02-06
- 2021-02-13
- 2021-02-20
-
2021-02-27
Dose 2 — Moderna
-
2021-02-27
Health check-in — day 0, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Feeling cold, Headache, Hyperhidrosis, Self-medication, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: After 12 hours, which was 2:00am I woke up with shivering and shaking extremely cold. Out on long underwear, socks. Back to bed. That went on till 4:30 am. Then it switched to sweating. Took off long underwear. That went on till 6:30 am. Got up with an extreme headache. Took Advil, headache is going away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · HeadacheFree text: Injection sightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
-
2021-03-15
Survey response — day 14, dose 2MedDRA: Cough, Dyspnoea, Increased upper airway secretion, Medical counselling, Nasal congestion, Nasopharyngitis, SARS-CoV-2 test negative, Sneezing — Feeling: PoorFree text: Clogged nose, cough, sneezing, restricted breathing, mucus in throat. I did have a rapid Covid-19 test today, was negative. Dr thought it is a bad cold.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-05-31
-
2021-08-28
Survey response — 6 months, dose 2MedDRA: Atypical pneumonia, COVID-19, Medical counselling, Office visit — Feeling: Poor · Get care from a doctor or other healthcare professionalFree text: Symptoms: Got COVID-19 on July 25, sick for 3 weeks, then good for 1 week now sick again since Monday August 23, Dr says Post COVID-19, beginning of walking pneumonia · Healthcare visit (other): My internist & AllergistMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-28
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-12-14
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna | |
| 2 | 2021-02-27 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-28 | Successful 2021-12-14 |
Does not wish to fill out VAERS report |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): After 12 hours, which was 2:00am I woke up with shivering and shaking extremely cold. Out on long underwear, socks. Back to bed. That went on till 4:30 am. Then it switched to sweating. Took off long underwear. That went on till 6:30 am. Got up with an extreme headache. Took Advil, headache is going away.
Systemic reaction (other): Injection sight
Release 5 — day 14, dose 2
Symptoms: Clogged nose, cough, sneezing, restricted breathing, mucus in throat. I did have a rapid Covid-19 test today, was negative. Dr thought it is a bad cold.
Release 9 — 6 months, dose 2
Symptoms: Got COVID-19 on July 25, sick for 3 weeks, then good for 1 week now sick again since Monday August 23, Dr says Post COVID-19, beginning of walking pneumonia
Healthcare visit (other): My internist & Allergist
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | · | ✓ |
| SD | Atypical pneumonia | ✓ | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | COVID-19 | ✓ | · | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Increased upper airway secretion | ✓ | ✓ | ✓ |
| SD | Medical counselling | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Feeling cold | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release