5ZC-23671-08016
4 vaccinations
5 coded responses
40 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 537 / WI
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-12
Dose 1 — Moderna
-
2021-02-13
Registered in v-safe
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
-
2021-02-19
Survey response — day 7, dose 1MedDRA: Flatulence — Feeling: Fair · Headache, Nausea · Be unable to do your normal daily activitiesFree text: I feel Im not we do to ingesting something. Feel very gassy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-03-05
-
2021-03-12
Dose 2 — Moderna
- 2021-03-12
-
2021-03-13
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Slightly dizzyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-06-11
- 2021-09-10
-
2021-10-22
Dose 3 — Moderna
-
2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Chills, Headache, Injection site pain, Malaise, Pain, Pyrexia — Feeling: Good · Site: Pain · Be unable to do your normal daily activitiesFree text: When I got my booster on October 22, 2021 I became very sick that night but cdc did not text me. I had HA's, fever, chills, pain at injection site and pain down side of body starting at axillary area going down. All over body aches. Lasted over 48hrsMedDRA releases: 2024-11 · check-in free text available
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2022-01-21
-
2022-03-30
Dose 4 — Moderna
-
2022-04-15
Survey response — day 14, dose 4MedDRA: Dizziness — Feeling: Good · 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: Lightheaded But I believe not related to vaccines Started February 2022MedDRA releases: 2024-11 · check-in free text available
-
2022-04-15
Report sent to call center — day 14, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-20
-
2022-04-21
Call successfulNot applicable - Accidental Reporting
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-06-29
-
2022-09-28
Survey response — 6 months, dose 4MedDRA: SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activitiesFree text: Positive Covid pcr testMedDRA releases: 2024-11 · check-in free text available
- 2023-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-12 | Moderna | |
| 2 | 2021-03-12 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-03-30 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — day 7, dose 1
Systemic reaction (other): I feel Im not we do to ingesting something. Feel very gassy.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Slightly dizzy
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): When I got my booster on October 22, 2021 I became very sick that night but cdc did not text me. I had HA's, fever, chills, pain at injection site and pain down side of body starting at axillary area going down. All over body aches. Lasted over 48hrs cut off by CDC
Release 11 — day 14, dose 4
Symptoms: Lightheaded But I believe not related to vaccines Started February 2022
Release 12 — 6 months, dose 4
Symptoms: Positive Covid pcr test
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 | Dizziness | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Malaise | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release