2ZN-20121-37748
5 vaccinations
5 coded responses
54 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 983 / WA
- Registered
- 2021-01-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-22
Dose 1 — Moderna
-
2021-01-24
Registered in v-safe
-
2021-01-24
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-25
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-02-05
- 2021-02-12
-
2021-02-19
Dose 2 — Moderna
- 2021-02-19
-
2021-02-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-21
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-03-05
- 2021-03-13
- 2021-03-19
- 2021-03-26
- 2021-04-04
- 2021-05-21
- 2021-08-20
-
2021-10-22
Dose 3 — ModernaCo-administered: Flu
- 2021-10-24
- 2021-10-25
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-11-07
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
-
2022-01-21
Survey response — 3 months, dose 3MedDRA: Headache, Influenza like illness, Pain, SARS-CoV-2 test negative — Feeling: GoodFree text: Mild flu-like symptoms that came and went several times I. The course of one week. Last symptoms were about 10 days ago. Symptoms included mild headache and mild body aches. An at home test was negative for COVID-19.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-11
Dose 4 — Moderna
-
2022-04-14
Survey response — days 1–6 daily, dose 4MedDRA: Influenza like illness — Feeling: Good · Site: PainFree text: Felt flu-like side effects from the vaccine on the day after the injection.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-15
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-25
- 2022-05-02
- 2022-05-09
- 2022-05-16
- 2022-05-23
-
2022-07-11
Survey response — 3 months, dose 4MedDRA: Fatigue, Influenza like illness — Feeling: GoodFree text: Fatigue, mild flu-like symptoms.MedDRA releases: 2024-11 · check-in free text available
-
2022-09-08
Dose 5 — Moderna
-
2022-09-15
Survey response — day 7, dose 5MedDRA: Influenza like illness — Feeling: GoodFree text: Experienced mild flu-like side effects from the September 8th boosterMedDRA releases: 2024-11 · check-in free text available
- 2022-09-22
- 2022-09-29
- 2022-10-06
- 2022-10-14
- 2022-10-20
-
2022-12-08
Survey response — 3 months, dose 5MedDRA: COVID-19, Post-acute COVID-19 syndrome, SARS-CoV-2 test positive — Feeling: Fair · 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: Contracted COVID-19 on October 22nd, tested positive until November 1st and now suffering from long covid.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-08
Report sent to call center — 3 months, 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)
- 2022-12-09
-
2022-12-12
Call successfulCompleted over the phone
- 2023-03-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-19 | Moderna | |
| 3 | 2021-10-22 | Moderna | Flu |
| 4 | 2022-04-11 | Moderna | No |
| 5 | 2022-09-08 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 11 — 3 months, dose 3
Symptoms: Mild flu-like symptoms that came and went several times I. The course of one week. Last symptoms were about 10 days ago. Symptoms included mild headache and mild body aches. An at home test was negative for COVID-19.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Felt flu-like side effects from the vaccine on the day after the injection.
Release 12 — 3 months, dose 4
Symptoms: Fatigue, mild flu-like symptoms.
Release 12 — day 7, dose 5
Systemic reaction (other): Experienced mild flu-like side effects from the September 8th booster
Release 12 — 3 months, dose 5
Symptoms: Contracted COVID-19 on October 22nd, tested positive until November 1st and now suffering from long covid.
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 | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Post-acute COVID-19 syndrome | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Influenza like illness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release