ZVW-22024-74204
2 vaccinations
2 coded responses
13 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 995 / AK
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Registered in v-safe
-
2021-01-11
Dose 1 — Moderna
- 2021-01-11
- 2021-01-12
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-25
- 2021-02-01
-
2021-02-05
Dose 2 — Moderna
-
2021-02-08
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Chills, Mobility decreased, Pain — Feeling: Good · Chills · Be unable to do your normal daily activitiesFree text: I had body aches in arm and lower back pain. I had body chills the following 24 hours after dose. Really couldnt get out of bed but aft 24-26 hours it seemed like everything went away and have been fine sinceMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
- 2021-02-11
-
2021-08-07
Survey response — 6 months, dose 2MedDRA: Atrial fibrillation, Cardiac failure, Hospitalisation, Ventricular tachycardia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: HEart failure. I was in the hospital twice in since June. On meds now that I hope have it under controlI was having Vtac then went into Afib, needed to be shocked to end the Afib episode.This was quite a surprise considering I am in good shapeMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-07
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)
-
2021-10-11
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-02-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-05 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): I had body aches in arm and lower back pain. I had body chills the following 24 hours after dose. Really couldnt get out of bed but aft 24-26 hours it seemed like everything went away and have been fine since
Release 9 — 6 months, dose 2
Symptoms: HEart failure. I was in the hospital twice in since June. On meds now that I hope have it under controlI was having Vtac then went into Afib, needed to be shocked to end the Afib episode.This was quite a surprise considering I am in good shape
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 | Atrial fibrillation | ✓ | · | ✓ |
| SD | Cardiac failure | ✓ | · | ✓ |
| SD | Hospitalisation | ✓ | · | ✓ |
| SD | Ventricular tachycardia | ✓ | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Mobility decreased | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release