NZF-12554-89507
2 vaccinations
6 coded responses
22 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 985 / WA
- Registered
- 2021-03-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-22
Registered in v-safe
-
2021-03-22
Dose 1 — Moderna
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-27
- 2021-03-28
- 2021-03-29
-
2021-04-05
Survey response — 14 day, dose 1MedDRA: Injection site pruritus — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-15
-
2021-04-20
Dose 2 — Moderna
-
2021-04-20
Health check-in — 0 day, dose 2Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body achesAdult check-in
-
2021-04-20
Survey response — 28 day, dose 1MedDRA: Injection site pain — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-04-22
- 2021-04-24
- 2021-05-07
-
2021-05-11
Survey response — 21 day, dose 2MedDRA: Hyperhidrosis — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-18
Survey response — 28 day, dose 2MedDRA: Night sweats — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-05-27
- 2021-06-02
- 2021-07-20
-
2021-10-19
Survey response — 6 month, dose 2MedDRA: Extrasystoles — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11 · check-in answers available
-
2021-10-19
Report sent to call center — 6 month, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-10-21
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-21
Survey response — 12 month, dose 2MedDRA: Arrhythmia — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-22 | Moderna | |
| 2 | 2021-04-20 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-19 | Successful 2021-10-21 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 6
Symptoms: Minor itchiness at the site of the vaccine injection is new.
Release 7
Symptoms: Some soreness/tightness at the site of COVID-19 injection.
Release 8
Symptoms: Some excess perspiration during sleep.
Symptoms: Nighttime sweating
Release 10
Symptoms: Ectopic heartbeat
Release 11
Symptoms: Continued heart arrhythmia.
Free-text releases are not linked to a specific 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 | Arrhythmia | · | · | ✓ |
| SD | Extrasystoles | · | · | ✓ |
| SD | Hyperhidrosis | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Night sweats | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release