5ZD-30279-57009
4 vaccinations
4 coded responses
35 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 050 / VT
- Registered
- 2021-04-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Dose 1 — Moderna
-
2021-04-02
Registered in v-safe
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-06
- 2021-04-07
- 2021-04-14
- 2021-04-21
-
2021-04-28
Dose 2 — Moderna
- 2021-04-28
- 2021-04-29
-
2021-04-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-01
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-08
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
- 2021-07-28
- 2021-10-27
-
2021-11-19
Dose 3 — Moderna
- 2022-04-28
-
2022-05-02
Dose 4 — Moderna
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-08
-
2022-05-09
Survey response — day 7, dose 4MedDRA: Gait inability, Muscle spasms, Pain in extremity — Feeling: Good · Chills, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Had a muscle spasm in my foot that was excruciatingly painful. It lasted almost 18 hours. I couldn't walk. I've never experienced anything like it before.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-16
Survey response — day 14, dose 4MedDRA: Urticaria — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: I got a severe case of hives on May 13 with no change of normal routines or patterns of eating or living. I've never had hives before and now hives cover my whole body. They are still severe as of today, Day 5.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-16
Report sent to call center — day 14, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
-
2022-05-17
Call successfulParticipant prefers to complete VAERS report online
-
2022-05-24
Survey response — day 21, dose 4MedDRA: Office visit, Self-medication, Urticaria — Feeling: Poor · 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: Terrible hives. Never had them before. Having to take high doses to antihistamine to manage symptoms. Have seen dermatologist for assistance. Will file Adverse Event Report.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-24
Report sent to call center — day 21, 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)
- 2022-05-25
- 2022-06-08
- 2022-06-15
-
2023-05-02
Survey response — 12 months, dose 4MedDRA: COVID-19, Self-medication, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-05-02
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-05-03
Call successfulCompleted over the phone
-
2023-05-03
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-28 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-05-02 | Moderna | No |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 2
Free text
Release 11 — day 7, dose 4
Systemic reaction (other): Had a muscle spasm in my foot that was excruciatingly painful. It lasted almost 18 hours. I couldn't walk. I've never experienced anything like it before.
Release 11 — day 14, dose 4
Symptoms: I got a severe case of hives on May 13 with no change of normal routines or patterns of eating or living. I've never had hives before and now hives cover my whole body. They are still severe as of today, Day 5.
Release 11 — day 21, dose 4
Symptoms: Terrible hives. Never had them before. Having to take high doses to antihistamine to manage symptoms. Have seen dermatologist for assistance. Will file Adverse Event Report.
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 | COVID-19 | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Gait inability | · | · | ✓ |
| SRO | Muscle spasms | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release