Z3G-26552-73410
5 vaccinations
8 coded responses
49 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 972 / OR
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-17
Registered in v-safe
-
2021-01-17
Dose 1 — Moderna
- 2021-01-17
- 2021-01-18
-
2021-01-19
Survey response — days 1–6 daily, dose 1MedDRA: Arthritis, Head discomfort, Pre-existing disease — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tirednessFree text: My head feels like it does when I have not had enough iron. And my arthritis in my back is worse than usualMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
-
2021-01-31
Survey response — day 14, dose 1MedDRA: Arthritis, Osteoporosis, Pre-existing disease — Feeling: FairFree text: I have arthritis and osteoporosis in my back and my lower back has been hurting more in the last week. I dont know if its that shot or barometric pressure change.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-07
Survey response — day 21, dose 1MedDRA: Arthritis, Pre-existing disease — Feeling: GoodFree text: Arthritis in my back is worse than usual. But it is better than last week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
-
2021-02-20
Dose 2 — Moderna
-
2021-02-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-22
-
2021-02-23
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: GoodFree text: Periodically Light headedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-24
- 2021-02-26
- 2021-02-27
-
2021-03-06
Survey response — day 14, dose 2MedDRA: Defaecation urgency, Dizziness, Fatigue — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesFree text: Day 11: woke up feeling okay. 30 minutes I felt a rushed need for a bowel movement.I felt like I would faint. Laid down on floor. 10 minutes my bowels emptied before I could get up. Total exhaustion and slept for the next 30 hours. No pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-05-22
- 2021-08-22
- 2022-02-20
-
2022-04-12
Dose 3 — Moderna
-
2022-04-24
Dose 4 — Moderna
-
2022-04-25
Survey response — days 1–6 daily, dose 4MedDRA: Nerve injury, Office visit, Pain — Feeling: Fair · Muscle or body aches · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): I saw the chiropractor today and she said my aches and pains are probably directly related to my ongoing nerve damage in my lower back · Healthcare visit (other): Regular chiropractic appointmentMedDRA releases: 2024-11 · check-in free text available
-
2022-04-25
Report sent to call center — days 1–6 daily, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-04-26
- 2022-04-26
- 2022-04-27
- 2022-04-27
-
2022-04-27
Call successfulCompleted over the phone
- 2022-04-28
- 2022-04-29
- 2022-04-30
- 2022-05-01
- 2022-05-08
- 2022-05-15
- 2022-05-22
- 2022-05-31
- 2022-06-05
-
2022-07-24
Survey response — 3 months, dose 4MedDRA: Laboratory test abnormal, Medical counselling — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: I tested positive June 7. I took pack (b)(6) that day and was without symptoms by Friday. · Healthcare visit (other): I talked with the doctor and she ordered paxlovidMedDRA releases: 2024-11 · check-in free text available
-
2022-07-24
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-07-25
- 2022-07-25
-
2022-07-25
Call successfulCompleted over the phone
-
2022-09-16
Dose 5 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-18
- 2022-09-19
- 2022-09-20
-
2022-09-21
Health check-in — days 1–6 daily, dose 5Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-09-22
- 2022-09-23
- 2022-09-30
- 2022-10-16
- 2022-10-21
- 2022-10-28
- 2022-12-16
-
2023-03-17
Survey response — 6 months, dose 5MedDRA: Diarrhoea, Hospitalisation, Influenza, SARS-CoV-2 test negative, Syncope, Vomiting — 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, HospitalizationMedDRA releases: 2024-11
-
2023-03-17
Report sent to call center — 6 months, dose 5Be 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)
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-17 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2022-04-12 | Moderna | No |
| 4 | 2022-04-24 | Moderna | No |
| 5 | 2022-09-16 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-25 | Successful 2022-04-27 |
Completed over the phone |
| 2022-07-24 | Successful 2022-07-25 |
Completed over the phone |
| 2023-03-17 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): My head feels like it does when I have not had enough iron. And my arthritis in my back is worse than usual
Release 3 — day 14, dose 1
Symptoms: I have arthritis and osteoporosis in my back and my lower back has been hurting more in the last week. I dont know if its that shot or barometric pressure change.
Release 3 — day 21, dose 1
Symptoms: Arthritis in my back is worse than usual. But it is better than last week.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Periodically Light headed
Release 5 — day 14, dose 2
Symptoms: Day 11: woke up feeling okay. 30 minutes I felt a rushed need for a bowel movement.I felt like I would faint. Laid down on floor. 10 minutes my bowels emptied before I could get up. Total exhaustion and slept for the next 30 hours. No pain.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): I saw the chiropractor today and she said my aches and pains are probably directly related to my ongoing nerve damage in my lower back
Healthcare visit (other): Regular chiropractic appointment
Release 12 — 3 months, dose 4
Symptoms: I tested positive June 7. I took pack (b)(6) that day and was without symptoms by Friday.
Healthcare visit (other): I talked with the doctor and she ordered paxlovid
redacted (b)(6)
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 |
|---|---|---|---|---|
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Arthritis | ✓ | ✓ | ✓ |
| SD | Defaecation urgency | ✓ | ✓ | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Laboratory test abnormal | · | · | ✓ |
| SD | Osteoporosis | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Syncope | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Arthritis | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Head discomfort | ✓ | ✓ | ✓ |
| SRO | Nerve injury | · | · | ✓ |
| SRO | Office visit | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release