3Z2-17742-01804
5 vaccinations
3 coded responses
46 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 801 / CO
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-06
- 2021-01-11
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-31
- 2021-02-01
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
-
2021-04-26
Survey response — 3 months, dose 2MedDRA: Ageusia, Bone pain, Disturbance in attention, Insomnia, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: I had major bone pain, couldn't sleep, couldn't focus for about 3 weeks. I woke up one morning and i was cogent, had slept and was fine. Taste still not back but getting better. · Healthcare visit (other): Had a dr. Appt that sent me to a mental health therapist, by that time i was fine. therapistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-26
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-07-26
Survey response — 6 months, dose 2MedDRA: Fatigue, Memory impairment — 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: I am always tired. I have difficulty remembering things, dates and appointments.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-26
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)
- 2021-08-03
-
2021-08-10
Call successfulCompleted over the phone
-
2021-09-02
Dose 3 — Moderna
- 2021-12-03
- 2022-03-03
-
2022-03-29
Dose 4 — Moderna
- 2022-04-14
- 2022-04-19
- 2022-04-26
- 2022-05-03
- 2022-05-10
-
2022-06-28
Survey response — 3 months, dose 4MedDRA: Diarrhoea, Weight decreased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I don't think covid related. Internal. Constant diarrhea and weight lossMedDRA releases: 2024-11 · check-in free text available
-
2022-06-28
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-06-29
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-09-20
Dose 5 — Pfizer-BioNTech
- 2022-09-20
- 2022-09-21
-
2022-09-22
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-09-23
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-09-25
- 2022-09-26
- 2022-09-27
- 2022-10-04
- 2022-10-11
- 2022-10-18
- 2022-10-25
- 2022-11-01
- 2022-12-20
- 2023-03-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna | |
| 3 | 2021-09-02 | Moderna | No |
| 4 | 2022-03-29 | Moderna | No |
| 5 | 2022-09-20 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 2
Free text
Release 8 — 3 months, dose 2
Symptoms: I had major bone pain, couldn't sleep, couldn't focus for about 3 weeks. I woke up one morning and i was cogent, had slept and was fine. Taste still not back but getting better.
Healthcare visit (other): Had a dr. Appt that sent me to a mental health therapist, by that time i was fine. therapist
Release 9 — 6 months, dose 2
Symptoms: I am always tired. I have difficulty remembering things, dates and appointments.
Release 12 — 3 months, dose 4
Symptoms: I don't think covid related. Internal. Constant diarrhea and weight loss
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Ageusia | ✓ | ✓ | ✓ |
| SD | Bone pain | ✓ | ✓ | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Disturbance in attention | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Memory impairment | ✓ | · | ✓ |
| SD | Weight decreased | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release