4ZM-15525-45195
3 vaccinations
4 coded responses
25 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 217 / MD
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-31
Dose 1 — Moderna
-
2021-01-29
Dose 2 — Moderna
-
2021-01-30
Registered in v-safe
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
-
2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-02-07
- 2021-02-12
- 2021-02-19
-
2021-02-28
Survey response — day 28, dose 2MedDRA: Headache — Feeling: FairFree text: Occasional headachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-12
- 2021-04-30
- 2021-07-31
-
2021-10-25
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · HeadacheFree text: I teceived the first Shingrix vaccine yesterday.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
-
2022-01-24
Survey response — 3 months, dose 3MedDRA: Condition aggravated, Diarrhoea, Pre-existing disease — Feeling: FairFree text: Diarrhea x 1mo but it has subsided. GI more sensitive than it used to be. I have no idea what has caused it.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-26
Survey response — 6 months, dose 3MedDRA: Depression, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I never mentioned it in previous checkins because i always suffer with increased anxiety/depression during the winter months. After thinking about it, i decided to mention that my anxiety/depression was greater this past winter than typical.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-26
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-05-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-31 | Moderna | |
| 2 | 2021-01-29 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 4 — day 28, dose 2
Symptoms: Occasional headaches
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I teceived the first Shingrix vaccine yesterday.
Release 11 — 3 months, dose 3
Symptoms: Diarrhea x 1mo but it has subsided. GI more sensitive than it used to be. I have no idea what has caused it.
Release 11 — 6 months, dose 3
Symptoms: I never mentioned it in previous checkins because i always suffer with increased anxiety/depression during the winter months. After thinking about it, i decided to mention that my anxiety/depression was greater this past winter than typical.
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 | Condition aggravated | · | · | ✓ |
| SD | Depression | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release