3TZ-27781-08044
3 vaccinations
6 coded responses
36 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 833 / ID
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Registered in v-safe
-
2021-02-05
Dose 1 — Moderna
- 2021-02-05
-
2021-02-06
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Headache · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-07
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: Pain · DiarrheaFree text: I have IBS diarrhea isn't uncommon for me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-19
- 2021-02-26
-
2021-03-05
Dose 2 — Moderna
- 2021-03-05
-
2021-03-06
Survey response — days 1–6 daily, dose 2MedDRA: Migraine, Vaccine positive rechallenge — Feeling: Poor · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesFree text: Just like the first shot the second triggered a migraineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Cough — Feeling: Good · Site: Redness, Swelling · Fever · Fatigue or tirednessFree text: Slight dry coughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-03-09
-
2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Fatigue or tirednessAdult check-in
-
2021-03-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Headache, Fatigue or tirednessAdult check-in
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-18
- 2021-06-04
-
2021-10-28
Dose 3 — Moderna
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Arthralgia, Headache, Pyrexia — Feeling: Good · Site: Redness, Itching · HeadacheFree text: 14 hours after receiving dose 3 i began experiencing headache, joint aches and fever. The highest fever was 101.5 . Symptoms ended in a day and a half.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Itching · NoneAdult check-in
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Itching · Fatigue or tirednessAdult check-in
- 2021-11-07
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-03
- 2021-12-09
- 2022-01-27
-
2022-04-29
Survey response — 6 months, dose 3MedDRA: Gastrooesophageal reflux disease, Office visit, Pancreatitis acute — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Acute pancreatitis. This has never happened to me before. My gastrointestinal doctor whom i see for acid reflux says that i do not consum enough alcohol for that to have caused acute pancreatitis. At this time there is no explanation for it.MedDRA releases: 2024-11 · check-in free text available
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2022-04-29
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-05-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-31
Survey response — 12 months, dose 3MedDRA: Cough, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activitiesFree text: I tested positive for Covid-19 on 7/19/22 fever, body aches, dry deep cough, sore throat.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | |
| 2 | 2021-03-05 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): I have IBS diarrhea isn't uncommon for me.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Just like the first shot the second triggered a migraine
Systemic reaction (other): Slight dry cough
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): 14 hours after receiving dose 3 i began experiencing headache, joint aches and fever. The highest fever was 101.5 . Symptoms ended in a day and a half.
Release 11 — 6 months, dose 3
Symptoms: Acute pancreatitis. This has never happened to me before. My gastrointestinal doctor whom i see for acid reflux says that i do not consum enough alcohol for that to have caused acute pancreatitis. At this time there is no explanation for it.
Release 12 — 12 months, dose 3
Symptoms: I tested positive for Covid-19 on 7/19/22 fever, body aches, dry deep cough, sore throat.
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 | Cough | · | · | ✓ |
| SD | Gastrooesophageal reflux disease | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pancreatitis acute | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Migraine | ✓ | ✓ | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release