4ZE-19725-28206
2 vaccinations
4 coded responses
14 check-ins
4 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 208 / MD
- Registered
- 2021-02-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-09
Registered in v-safe
-
2021-02-09
Dose 1 — Moderna
-
2021-02-09
Survey response — day 0, dose 1MedDRA: Erythema — Feeling: GoodFree text: Face a little red, but no feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
- 2021-02-12
-
2021-02-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Joint pains, Muscle or body achesAdult check-in
-
2021-02-15
Survey response — days 1–6 daily, dose 1MedDRA: Diarrhoea — Feeling: Good · Muscle or body aches, DiarrheaFree text: Loose stools the last two daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-02-24
- 2021-03-02
-
2021-03-10
Dose 2 — Moderna
-
2021-03-17
Health check-in — day 7, dose 2Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-24
-
2021-03-31
Survey response — day 21, dose 2MedDRA: Office visit, Pre-existing disease, Urinary tract infection, Urine odour abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: After my first shot, I got a urinary tract infection. First one in over 60 years. Dont know if it is a coincidence, but Im being checked for another urinary tract infection following my second shot. Very strong smelling urine. Waiting on res · Healthcare visit (other): A urine sample was left at doctors office. Awaiting results. Very strong smelling urine like after the first injection. Note: (b)(6)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-31
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-22
- 2021-06-09
-
2021-09-10
Survey response — 6 months, dose 2MedDRA: Arthralgia, Asthenia, Medical counselling, Muscular weakness, Pneumonia, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Urinary, treated for pneumonia, weakened legs and strength, more joint pain than before the shot · Healthcare visit (other): Doctor did a home visit to assess how to treatMedDRA releases: 2024-11 · check-in free text available
-
2021-09-10
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-13
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-09 | Moderna | |
| 2 | 2021-03-10 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 3 — day 0, dose 1
Systemic reaction (other): Face a little red, but no fever
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Loose stools the last two days
Release 6 — day 21, dose 2
Symptoms: After my first shot, I got a urinary tract infection. First one in over 60 years. Dont know if it is a coincidence, but Im being checked for another urinary tract infection following my second shot. Very strong smelling urine. Waiting on res
Healthcare visit (other): A urine sample was left at doctors office. Awaiting results. Very strong smelling urine like after the first injection. Note: (b)(6)
redacted (b)(6)
Release 9 — 6 months, dose 2
Symptoms: Urinary, treated for pneumonia, weakened legs and strength, more joint pain than before the shot
Healthcare visit (other): Doctor did a home visit to assess how to treat
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 | Medical counselling | · | · | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| HCVO | Pre-existing disease | ✓ | ✓ | ✓ |
| HCVO | Urine odour abnormal | ✓ | ✓ | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Muscular weakness | · | · | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Urinary tract infection | ✓ | ✓ | ✓ |
| SD | Urine odour abnormal | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release