4ZQ-17580-38112
5 vaccinations
8 coded responses
66 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 895 / NV
- Registered
- 2020-12-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-27
Registered in v-safe
-
2020-12-27
Dose 1 — Moderna
- 2020-12-27
-
2020-12-28
Survey response — days 1–6 daily, dose 1MedDRA: Chest pain, Self-medication — Feeling: Good · Site: Pain · Muscle or body achesFree text: Had a chest pain last night, took 1 otc ibuprofen and good todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
-
2021-01-10
Survey response — day 14, dose 1MedDRA: Axillary pain, Breast pain, Injection site pruritus, Injection site swelling — Feeling: GoodFree text: Itching & mild swelling in 2†diameter area around injection site, aching armpit and upper outer breast on same side as injection. These symptoms occurred day 8-10 post vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-17
-
2021-01-24
Dose 2 — Moderna
-
2021-01-24
Health check-in — day 0, dose 2Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
-
2021-01-25
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-01-27
Survey response — days 1–6 daily, dose 2MedDRA: Irritability — Feeling: Good · Site: Pain, ItchingFree text: Feeling Irritable and felt irritable yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
-
2021-02-07
Survey response — day 14, dose 2MedDRA: Chills, Fatigue, Pyrexia — Feeling: Good · Be unable to do your normal daily activitiesFree text: On 02/03/21 I had a fever,chills, and fatigue just like what I experienced on the day following the 2nd COVID-19 dose. I reported it on VAERS cdc site referencing my v-safe registration code. I felt fine the following day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
- 2021-02-21
- 2021-02-28
- 2021-03-07
-
2021-04-25
Survey response — 3 months, dose 2MedDRA: Pain — Feeling: GoodFree text: Had an adverse reaction to a pain medication resulting in syncope.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-25
-
2021-12-01
Dose 3 — Moderna
- 2021-12-01
-
2021-12-02
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-12-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Joint painsAdult check-in
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-08
- 2021-12-15
- 2021-12-22
- 2021-12-29
- 2022-01-05
- 2022-01-12
- 2022-03-02
-
2022-05-06
Dose 4 — Moderna
- 2022-05-06
-
2022-05-07
Survey response — days 1–6 daily, dose 4MedDRA: Vertigo — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains · Be unable to do your normal daily activitiesFree text: VertigoMedDRA releases: 2024-11 · check-in free text available
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2022-05-08
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2022-05-09
- 2022-05-10
- 2022-05-11
- 2022-05-12
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-06-10
-
2022-06-19
Survey response — day 42, dose 4MedDRA: Cough, Oropharyngeal pain, Upper respiratory tract congestion — Feeling: FairFree text: sore throat, congested upper respiratory, slight cough,MedDRA releases: 2024-11 · check-in free text available
- 2022-08-05
-
2022-10-03
Dose 5 — Pfizer-BioNTech
- 2022-10-03
-
2022-10-04
Health check-in — days 1–6 daily, dose 5Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2022-10-05
- 2022-10-06
- 2022-10-08
- 2022-10-09
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-11-01
- 2022-11-07
- 2022-11-14
-
2023-01-02
Survey response — 3 months, dose 5MedDRA: Cholecystectomy — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-27 | Moderna | |
| 2 | 2021-01-24 | Moderna | |
| 3 | 2021-12-01 | Moderna | No |
| 4 | 2022-05-06 | Moderna | No |
| 5 | 2022-10-03 | Pfizer-BioNTech | No |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Had a chest pain last night, took 1 otc ibuprofen and good today
Release 1 — day 14, dose 1
Symptoms: Itching & mild swelling in 2†diameter area around injection site, aching armpit and upper outer breast on same side as injection. These symptoms occurred day 8-10 post vaccination.
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Feeling Irritable and felt irritable yesterday
Release 3 — day 14, dose 2
Symptoms: On 02/03/21 I had a fever,chills, and fatigue just like what I experienced on the day following the 2nd COVID-19 dose. I reported it on VAERS cdc site referencing my v-safe registration code. I felt fine the following day.
Release 7 — 3 months, dose 2
Symptoms: Had an adverse reaction to a pain medication resulting in syncope.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Vertigo
Release 12 — day 42, dose 4
Symptoms: sore throat, congested upper respiratory, slight cough,
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 | Axillary pain | ✓ | ✓ | ✓ |
| SD | Breast pain | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Cholecystectomy | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Upper respiratory tract congestion | · | · | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Irritability | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Vertigo | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release