92C-78331-88076
1 vaccination
1 coded response
8 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 068 / CT
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Dose 1 — Moderna
-
2021-01-28
Registered in v-safe
- 2021-01-28
- 2021-01-29
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-09
- 2021-02-16
-
2022-01-26
Survey response — 12 months, dose 1MedDRA: Herpes zoster — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Shingles over the left eyelidMedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
Report sent to call center — 12 months, dose 1Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-27
-
2022-02-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 11 — 12 months, dose 1
Symptoms: Shingles over the left eyelid
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 | Herpes zoster | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release