XZN-60723-28828
5 vaccinations
16 coded responses
53 check-ins
16 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 302 / GA
- Registered
- 2021-03-09
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-09
Registered in v-safe
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2021-03-09
Dose 1 — Moderna
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2021-03-09
Survey response — day 0, dose 1MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-10
-
2021-03-11
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Erythema, Pruritus — Feeling: GoodFree text: Itching and redness lower back yesterday evening and earlier today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
-
2021-04-07
Dose 2 — Moderna
-
2021-04-07
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: GoodFree text: No. I received it at 3:15pMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: My normal temperature is 97.7MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness · Fatigue or tirednessAdult check-in
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2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Somnolence — Feeling: GoodFree text: Sleepy at times but feeling well and relieved.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: Good · Fatigue or tirednessFree text: Mild fatigue on occasion only.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
- 2021-04-13
-
2021-04-14
Survey response — day 7, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
- 2021-04-28
- 2021-05-05
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2021-05-12
Survey response — day 35, dose 2MedDRA: Tongue disorder — Feeling: GoodFree text: Bump on my tongue. Checks mildly irritated. Cause may have been due to acidic food.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-19
- 2021-07-07
- 2021-10-06
-
2021-10-21
Dose 3 — Moderna
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2021-10-29
Survey response — day 7, dose 3MedDRA: Throat irritation, Upper-airway cough syndrome — Feeling: Good · Fatigue or tirednessFree text: Postnatal drip, itchy throatMedDRA releases: 2024-11 · check-in free text available
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2021-11-04
Survey response — day 14, dose 3MedDRA: Abdominal discomfort, Lethargy, Respiratory disorder — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Lethargic, abdominal discomfort, mild breathing disorder (may have been asthma or gastric).MedDRA releases: 2024-11 · check-in free text available
- 2021-11-12
- 2021-11-18
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2021-11-25
Survey response — day 35, dose 3MedDRA: Pre-existing disease, Unevaluable event, Upper-airway cough syndrome — Feeling: GoodFree text: More postnasal drip. I was given a full dose as my booster. I have allergies and mild asthma. No fever.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-02
- 2022-01-20
- 2022-04-21
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2022-04-22
Dose 4 — Moderna
- 2022-05-18
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-07-22
-
2022-09-27
Dose 5 — Moderna
- 2022-09-27
- 2022-09-28
- 2022-09-29
-
2022-09-30
Survey response — days 1–6 daily, dose 5MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
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2022-10-01
Survey response — days 1–6 daily, dose 5MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
- 2022-10-02
- 2022-10-03
- 2022-10-04
- 2022-10-11
- 2022-10-18
- 2022-10-25
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2022-11-02
Survey response — day 35, dose 5MedDRA: Cough, Influenza like illness, Self-medication — Feeling: GoodFree text: Flue like symptoms after flue vaccine. Robitussin DM for cough.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-08
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2022-12-27
Survey response — 3 months, dose 5MedDRA: COVID-19, Hospitalisation — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Covid symptoms 11/22/22. Diagnosed & treated for Covid 11/28/22. Currently in hospital for non-Covid reasons (I believe).MedDRA releases: 2024-11 · check-in free text available
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2022-12-27
Report sent to call center — 3 months, dose 5Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-12-28
- 2022-12-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-09 | Moderna | |
| 2 | 2021-04-07 | Moderna | |
| 3 | 2021-10-21 | Moderna | No |
| 4 | 2022-04-22 | Moderna | No |
| 5 | 2022-09-27 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-27 | Unsuccessful |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): No
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): No
Systemic reaction (other): Itching and redness lower back yesterday evening and earlier today.
Release 7 — day 0, dose 2
Systemic reaction (other): No. I received it at 3:15p
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): My normal temperature is 97.7
Systemic reaction (other): Sleepy at times but feeling well and relieved.
Systemic reaction (other): Mild fatigue on occasion only.
Release 7 — day 7, dose 2
Systemic reaction (other): None
Release 8 — day 35, dose 2
Symptoms: Bump on my tongue. Checks mildly irritated. Cause may have been due to acidic food.
Release 10 — day 7, dose 3
Systemic reaction (other): Postnatal drip, itchy throat
Release 10 — day 14, dose 3
Symptoms: Lethargic, abdominal discomfort, mild breathing disorder (may have been asthma or gastric).
Release 10 — day 35, dose 3
Symptoms: More postnasal drip. I was given a full dose as my booster. I have allergies and mild asthma. No fever.
Release 12 — days 1–6 daily, dose 5
Release 12 — day 35, dose 5
Symptoms: Flue like symptoms after flue vaccine. Robitussin DM for cough.
Release 12 — 3 months, dose 5
Symptoms: Covid symptoms 11/22/22. Diagnosed & treated for Covid 11/28/22. Currently in hospital for non-Covid reasons (I believe).
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 | Abdominal discomfort | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Lethargy | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Tongue disorder | ✓ | ✓ | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
| SRO | Throat irritation | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Upper-airway cough syndrome | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release