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Z23-35688-00305

3 vaccinations 5 coded responses 37 check-ins 5 free-text entries 2 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
923 / CA
Registered
2020-12-30
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
85W-30477-62906 Child or adolescent in my care · Male · 2021-11-04
T2N-31116-49353 Child or adolescent in my care · Male · 2021-11-04

Timeline

  1. 2020-12-30
    Registered in v-safe
  2. 2020-12-30
    Dose 1 — Moderna
  3. 2020-12-30
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2020-12-31
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-01-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-02
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Muscle spasms — Feeling: Good · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Not sure if related but have a muscle spasm that developed on same side as injection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-01-04
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-01-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: Muscle spasms — Feeling: Fair · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities
    Free text: Same as yesterday not sure if related to the vaccine but am having a muscle spasm on same side I received the vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-01-05
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to work · Be unable to do your normal daily activities
    1 call case(s)
  12. 2021-01-06
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  13. 2021-01-15
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-01-22
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  15. 2021-01-28
    Dose 2 — Moderna
  16. 2021-01-28
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  17. 2021-01-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work
    Adult check-in
  18. 2021-01-30
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Nausea
    Adult check-in
  19. 2021-01-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-02-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-02-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-02-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  23. 2021-02-03
  24. 2021-02-04
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  25. 2021-02-11
    Survey response — day 14, dose 2
    MedDRA: Abdominal pain, Diarrhoea, Gastrointestinal disorder — Feeling: Good
    Free text: Some tummy troubles. Nothing crazy. Light diarrhea about 5-6 days ago.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-02-18
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-02-25
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-03-06
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-03-11
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  30. 2021-04-29
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  31. 2021-07-29
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  32. 2021-11-01
    Dose 3 — Moderna
  33. 2021-11-04
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  34. 2021-11-05
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  35. 2021-11-06
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-11-07
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  37. 2021-11-08
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  38. 2021-11-15
    Survey response — day 14, dose 3
    MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair
    Free text: Congestion and a sore throat
    MedDRA releases: 2024-11 · check-in free text available
  39. 2021-11-22
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-11-29
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  41. 2021-12-08
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  42. 2021-12-13
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  43. 2022-01-31
    Survey response — 3 months, dose 3
    MedDRA: Exposure to SARS-CoV-2, Fatigue, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Covid symptoms after my husband and oldest son tested positive. My first two tests were negative but had congestion/ sore throat and fatigue. Symptoms were mild.
    MedDRA releases: 2024-11 · check-in free text available
  44. 2022-05-04
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12020-12-30Moderna
22021-01-28Moderna
32021-11-01Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-01-04 Unsuccessful
2021-01-05 Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-04

Systemic reaction (other): Not sure if related but have a muscle spasm that developed on same side as injection

2021-01-05

Systemic reaction (other): Same as yesterday not sure if related to the vaccine but am having a muscle spasm on same side I received the vaccine

Release 4 — day 14, dose 2

2021-02-11

Symptoms: Some tummy troubles. Nothing crazy. Light diarrhea about 5-6 days ago.

Release 10 — day 14, dose 3

2021-11-15

Symptoms: Congestion and a sore throat

Release 11 — 3 months, dose 3

2022-01-31

Symptoms: Covid symptoms after my husband and oldest son tested positive. My first two tests were negative but had congestion/ sore throat and fatigue. Symptoms were mild.

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

FieldPreferred term2021-092023-042024-11
SDAbdominal pain ✓ ✓ ○
SDDiarrhoea ✓ ✓ ✓
SDExposure to SARS-CoV-2 · · ✓
SDFatigue · · ✓
SDGastrointestinal disorder · · ✓
SDOropharyngeal pain · · ✓
SDRespiratory tract congestion · · ✓
SDSARS-CoV-2 test negative · · ✓
SROMuscle spasms ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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