3ZE-18542-94248
4 vaccinations
10 coded responses
53 check-ins
9 free-text entries
6 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 925 / CA
- 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
- 2021-01-20
-
2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: Ear pain, Oropharyngeal pain — Feeling: GoodFree text: I missed report yesterday I had mild sore throat and earache with no fever gone todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-02-03
- 2021-02-10
- 2021-02-17
-
2021-02-22
Dose 2 — Moderna
- 2021-02-22
-
2021-02-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-24
-
2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Head discomfort, Musculoskeletal discomfort — Feeling: GoodFree text: Some pressure in my head especially back of neckMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-08
- 2021-03-15
-
2021-03-22
Survey response — day 28, dose 2MedDRA: Blood urine, Cystitis, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Bladder infection- blood in urine - under treatment · Healthcare visit (other): Urologist office visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-22
Report sent to call center — day 28, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-29
-
2021-04-05
Survey response — day 42, dose 2MedDRA: Headache, Pain — Feeling: GoodFree text: Radom shooting pain in head/brainMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-24
-
2021-08-23
Survey response — 6 months, dose 2MedDRA: Pre-existing disease, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Diverticulitis but I have a history of this so not due to vaccine · Healthcare visit (other): Not due to vaccineMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-23
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)
- 2021-08-24
-
2021-10-28
Dose 3 — Moderna
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
-
2022-01-27
Survey response — 3 months, dose 3MedDRA: Hospitalisation, Lipoma, Lipoma excision, Surgery — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Surgery today for lipoma on my back · Healthcare visit (other): Day surgery at hospitalMedDRA releases: 2024-11 · check-in free text available
-
2022-01-27
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
-
2022-02-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-30
-
2022-06-10
Dose 4 — Moderna
-
2022-06-11
Survey response — days 1–6 daily, dose 4MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: 6/10 10pm - 6/11 noon reaction to boosterMedDRA releases: 2024-11 · check-in free text available
- 2022-06-12
- 2022-06-13
- 2022-06-14
- 2022-06-15
- 2022-06-16
- 2022-06-17
- 2022-06-24
- 2022-07-01
- 2022-07-10
- 2022-07-15
-
2022-09-09
Survey response — 3 months, dose 4MedDRA: Muscular weakness, Nerve compression, Office visit, Pain in extremity, Physiotherapy — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Pain / weakness right foot/ leg due to pinched nerve being treated with physical therapy · Healthcare visit (other): Orthopedic doctorMedDRA releases: 2024-11 · check-in free text available
-
2022-09-09
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-09-13
- 2022-09-13
- 2022-09-13
-
2022-12-12
Survey response — 6 months, dose 4MedDRA: COVID-19, Medical counselling, SARS-CoV-2 test negative, SARS-CoV-2 test positive — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: COVID twice in a month Positive test 11/21:/22 - paxlivid 11/21-25 Negative test 11/28/22 Positive test 12/11/22 · Healthcare visit (other): My doctor on phoneMedDRA releases: 2024-11 · check-in free text available
-
2022-12-12
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-12-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-12-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-12-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-12-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-06-11
Survey response — 12 months, dose 4MedDRA: COVID-19, Choking, Cough, Headache, Office visit, Rhinorrhoea, Sinus disorder, Upper-airway cough syndrome — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-06-11
Call case (no matching report) — SuccessfulDoes not wish to fill out VAERS report
- 2023-06-12
-
2023-06-14
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-22 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-06-10 | Moderna | No |
Call center
6 call center cases
6 successful
1 wait over 3 months for a first call
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): I missed report yesterday I had mild sore throat and earache with no fever gone today
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Some pressure in my head especially back of neck
Release 6 — day 28, dose 2
Symptoms: Bladder infection- blood in urine - under treatment
Healthcare visit (other): Urologist office visit
Release 6 — day 42, dose 2
Symptoms: Radom shooting pain in head/brain
Release 9 — 6 months, dose 2
Symptoms: Diverticulitis but I have a history of this so not due to vaccine
Healthcare visit (other): Not due to vaccine
Release 11 — 3 months, dose 3
Symptoms: Surgery today for lipoma on my back
Healthcare visit (other): Day surgery at hospital
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): 6/10 10pm - 6/11 noon reaction to booster
Release 12 — 3 months, dose 4
Symptoms: Pain / weakness right foot/ leg due to pinched nerve being treated with physical therapy
Healthcare visit (other): Orthopedic doctor
Release 12 — 6 months, dose 4
Symptoms: COVID twice in a month Positive test 11/21:/22 - paxlivid 11/21-25 Negative test 11/28/22 Positive test 12/11/22
Healthcare visit (other): My doctor on phone
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 | Hospitalisation | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| HCVO | Surgery | · | · | ✓ |
| HCVO | Unevaluable event | ✓ | · | ✓ |
| SD | Blood urine | ✓ | ✓ | ✓ |
| SD | Choking | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Cystitis | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Lipoma | · | · | ✓ |
| SD | Lipoma excision | · | · | ✓ |
| SD | Muscular weakness | · | · | ✓ |
| SD | Nerve compression | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Physiotherapy | · | · | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinus disorder | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Head discomfort | ✓ | ✓ | ✓ |
| SRO | Immunisation reaction | · | · | ✓ |
| SRO | Musculoskeletal discomfort | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release