ZX8-13895-71712
5 vaccinations
3 coded responses
53 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 176 / PA
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Registered in v-safe
-
2021-01-20
Dose 1 — Moderna
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-02-03
- 2021-02-10
-
2021-02-17
Dose 2 — Moderna
- 2021-02-17
-
2021-02-18
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-05-19
- 2021-08-18
-
2021-10-23
Dose 3 — Moderna
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Chills — Feeling: GoodFree text: I did have chills 10 hr after the booster shot on 10/23, chills lasted 3-4 hr,,MedDRA releases: 2024-11 · check-in free text available
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-12-04
- 2022-01-22
-
2022-04-02
Dose 4 — Moderna
- 2022-04-23
- 2022-04-23
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-07-02
-
2022-09-16
Dose 5 — Pfizer-BioNTech
- 2022-09-16
-
2022-09-17
Survey response — days 1–6 daily, dose 5MedDRA: Pain in extremity, Reaction to previous exposure to any vaccine — Feeling: GoodFree text: Prior to this all vaccines Moderna (2+ 2 boosters). After second shot and 2 booster had chills ~12 hours after shot. After this pfizer bivariate shot, nothing but sore arm.MedDRA releases: 2024-11 · check-in free text available
- 2022-09-18
-
2022-09-19
Survey response — days 1–6 daily, dose 5MedDRA: Food poisoning, Living in residential institution, Vomiting — Feeling: Fair · Fatigue or tiredness · 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: Systemic reaction (other): Experienced severe vomiting last night. 95% sure it was the result of food poisoning. Felling better today! · Healthcare visit (other): We curently live in a CCRC and have 24/7 nursing availableMedDRA releases: 2024-11 · check-in free text available
-
2022-09-19
Report sent to call center — days 1–6 daily, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-09-20
-
2022-09-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-09-21
- 2022-09-22
- 2022-09-23
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-23
- 2022-10-28
- 2022-12-16
- 2023-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-17 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-02 | Moderna | No |
| 5 | 2022-09-16 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I did have chills 10 hr after the booster shot on 10/23, chills lasted 3-4 hr,,
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Prior to this all vaccines Moderna (2+ 2 boosters). After second shot and 2 booster had chills ~12 hours after shot. After this pfizer bivariate shot, nothing but sore arm.
Systemic reaction (other): Experienced severe vomiting last night. 95% sure it was the result of food poisoning. Felling better today!
Healthcare visit (other): We curently live in a CCRC and have 24/7 nursing available
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 | Living in residential institution | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Food poisoning | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release