2ZF-10494-44860
4 vaccinations
3 coded responses
11 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 950 / CA
- Registered
- 2021-07-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-06-02
Dose 1 — Moderna
-
2021-06-29
Dose 2 — Moderna
-
2021-07-17
Registered in v-safe
- 2021-07-17
- 2021-07-20
- 2021-07-28
- 2021-08-03
-
2021-08-10
Survey response — day 42, dose 2MedDRA: Headache, Paranasal sinus hypersecretion, Sinusitis, Toothache — Feeling: Good · Be unable to do your normal daily activitiesFree text: Sinus infection: headache, nasal drainage, toothacheMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-09-28
- 2021-12-28
-
2022-01-05
Dose 3 — Moderna
-
2022-09-30
Dose 4 — Moderna
-
2022-10-15
Survey response — day 14, dose 4MedDRA: Influenza, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Cold/flu symptomsMedDRA releases: 2024-11 · check-in free text available
-
2022-11-04
Survey response — day 35, dose 4MedDRA: COVID-19, Malaise — Feeling: Fair · Be unable to work or attend school, 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: Sick for past 4 weeks. Covid positive for past 11 days.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-04
Report sent to call center — day 35, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-07
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-12-30
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-02 | Moderna | No |
| 2 | 2021-06-29 | Moderna | No |
| 3 | 2022-01-05 | Moderna | No |
| 4 | 2022-09-30 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-04 | Successful 2022-11-07 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 9 — day 42, dose 2
Symptoms: Sinus infection: headache, nasal drainage, toothache
Release 12 — day 14, dose 4
Symptoms: Cold/flu symptoms
Release 12 — day 35, dose 4
Symptoms: Sick for past 4 weeks. Covid positive for past 11 days.
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 | COVID-19 | · | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | ✓ | · | ✓ |
| SD | Sinusitis | ✓ | · | ✓ |
| SD | Toothache | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release