Z2Z-21375-76376
5 vaccinations
7 coded responses
38 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 816 / CO
- Registered
- 2021-01-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Dose 1 — Moderna
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2021-01-10
Registered in v-safe
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2021-01-10
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-01-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-01-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Muscle or body aches, NauseaAdult check-in
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2021-01-13
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-14
- 2021-01-21
- 2021-01-28
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2021-02-04
Dose 2 — Moderna
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2021-02-04
Health check-in — day 0, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
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2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Pain, Self-medication, Sleep disorder — Feeling: Good · Site: Swelling, Itching · Headache, Muscle or body aches, Fatigue or tirednessFree text: Interrupted sleep the past two nights with some body aches. Even with taking Tylenol 8 hour. Also took Tylenol 8 hour during the day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Joint pains, Fatigue or tirednessAdult check-in
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2021-02-08
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction, Unevaluable event — Feeling: Good · HeadacheFree text: The second shot has been harder to get over. Symptoms have been more severe.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
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2021-03-18
Survey response — day 42, dose 2MedDRA: Arthralgia, Pre-existing disease — Feeling: FairFree text: Aching joints. Dont know if its old age,arthritis. Not enough exercise. Thats how I am feeling. Seem to be getting worse.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-06
Survey response — 3 months, dose 2MedDRA: Arthralgia, Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: They arent new. They are still lingering. Slight headaches and ache hips.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-05
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2021-12-20
Dose 3 — Moderna
- 2022-02-04
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2022-04-28
Dose 4 — Moderna
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2022-04-29
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2022-04-30
- 2022-05-01
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2022-05-02
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Headache, Joint pains, Muscle or body achesAdult check-in
- 2022-05-03
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2022-05-04
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Headache, Joint pains, Muscle or body achesAdult check-in
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2022-05-05
Health check-in — day 7, dose 4Feeling: Fair · Headache, Joint pains, Muscle or body achesAdult check-in
- 2022-05-12
- 2022-05-19
- 2022-05-26
- 2022-06-02
- 2022-06-09
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2022-07-28
Survey response — 3 months, dose 4MedDRA: COVID-19, Patient isolation — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I got Covid yesterday and I am isolated.MedDRA releases: 2024-11 · check-in free text available
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2022-07-28
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-07-29
Call successfulCompleted over the phone
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2022-10-28
Survey response — 6 months, dose 4MedDRA: Appendicitis, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: I had an ER appendicitis.MedDRA releases: 2024-11 · check-in free text available
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2022-10-28
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-10-31
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2022-11-28
Dose 5 — Pfizer-BioNTech
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2023-05-31
Survey response — 6 months, dose 5MedDRA: Appendicitis, Arthritis, Pre-existing disease, Sciatica — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
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2023-05-31
Call case (no matching report) — SuccessfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2023-06-01
Call successfulCompleted over the phone
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2023-06-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna | |
| 3 | 2021-12-20 | Moderna | No |
| 4 | 2022-04-28 | Moderna | No |
| 5 | 2022-11-28 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-28 | Successful 2022-07-29 |
Completed over the phone |
| 2022-10-28 | Successful 2023-06-01 |
Completed over the phone |
| 2023-05-31 | Successful 2023-06-01 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Interrupted sleep the past two nights with some body aches. Even with taking Tylenol 8 hour. Also took Tylenol 8 hour during the day.
Systemic reaction (other): The second shot has been harder to get over. Symptoms have been more severe.
Release 5 — day 42, dose 2
Symptoms: Aching joints. Dont know if its old age,arthritis. Not enough exercise. Thats how I am feeling. Seem to be getting worse.
Release 8 — 3 months, dose 2
Symptoms: They arent new. They are still lingering. Slight headaches and ache hips.
Release 12 — 3 months, dose 4
Symptoms: I got Covid yesterday and I am isolated.
Release 12 — 6 months, dose 4
Symptoms: I had an ER appendicitis.
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 | Appendicitis | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Arthritis | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Patient isolation | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Sciatica | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release