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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

  1. 2021-01-30
    Dose 1 — Moderna
  2. 2021-01-31
    Registered in v-safe
  3. 2021-01-31
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-02-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-02-02
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  8. 2021-02-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache
    Adult check-in
  9. 2021-02-06
    Health check-in — day 7, dose 1
    Feeling: Fair · Site: Pain · Headache
    Adult check-in
  10. 2021-02-13
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-20
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-27
    Dose 2 — Moderna
  13. 2021-02-27
    Health check-in — day 0, dose 2
    Feeling: Good · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  14. 2021-02-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: 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 activities
    Free 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
  15. 2021-03-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache
    Free text: Injection sight
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  17. 2021-03-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-03-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-03-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-03-06
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-03-15
    Survey response — day 14, dose 2
    MedDRA: Cough, Dyspnoea, Increased upper airway secretion, Medical counselling, Nasal congestion, Nasopharyngitis, SARS-CoV-2 test negative, Sneezing — Feeling: Poor
    Free 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
  22. 2021-03-20
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-27
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-03
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-10
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-31
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-08-28
    Survey response — 6 months, dose 2
    MedDRA: Atypical pneumonia, COVID-19, Medical counselling, Office visit — Feeling: Poor · Get care from a doctor or other healthcare professional
    Free 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 & Allergist
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  28. 2021-08-28
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  29. 2021-12-14
    Call successful
    Does not wish to fill out VAERS report

Vaccinations

DoseDateManufacturerCo-administered
12021-01-30Moderna
22021-02-27Moderna

Call center

ReportedOutcomeVAERS-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

2021-02-28

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.

2021-03-01

Systemic reaction (other): Injection sight

Release 5 — day 14, dose 2

2021-03-15

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

2021-08-28

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ · ✓
SDAtypical pneumonia ✓ · ✓
SDCough ✓ ✓ ✓
SDCOVID-19 ✓ · ✓
SDDyspnoea ✓ ✓ ✓
SDIncreased upper airway secretion ✓ ✓ ✓
SDMedical counselling ✓ ✓ ✓
SDNasal congestion ✓ ✓ ✓
SDNasopharyngitis ✓ ✓ ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓
SDSneezing ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROFeeling cold ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROHyperhidrosis ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓
SROTremor ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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