Z3N-61784-21939
5 vaccinations
6 coded responses
63 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 531 / WI
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Registered in v-safe
-
2021-03-31
Dose 1 — Moderna
- 2021-03-31
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2021-04-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-02
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2021-04-03
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
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2021-04-04
Survey response — days 1–6 daily, dose 1MedDRA: Erythema, Rash, Sinus disorder — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Rash on my face, roughly following the sinuses. Less red than yesterday. No itchMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-05
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Face rash nearly goneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
- 2021-04-07
- 2021-04-14
- 2021-04-21
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2021-04-28
Dose 2 — Moderna
- 2021-04-28
-
2021-04-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-30
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-03
- 2021-06-09
- 2021-07-28
- 2021-10-27
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2021-11-14
Dose 3 — Moderna
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2021-11-15
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Chills, Fatigue or tirednessAdult check-in
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2021-11-16
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Nausea, DiarrheaAdult check-in
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2021-11-17
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Swelling · Headache, Fatigue or tiredness, Nausea, DiarrheaAdult check-in
- 2021-11-18
- 2021-11-19
- 2021-11-20
- 2021-11-21
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2021-11-28
Survey response — day 14, dose 3MedDRA: Nasopharyngitis, Pre-existing disease — Feeling: FairFree text: Either severe allergy or head cold, started yesterday.MedDRA releases: 2024-11 · check-in free text available
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2021-12-05
Survey response — day 21, dose 3MedDRA: Nasopharyngitis, Oropharyngeal pain, Self-medication, Throat irritation, Upper-airway cough syndrome — Feeling: PoorFree text: Head cold for the 8th day; preceded with a scratchy then sore throat for 24 hours. Antihistamines help nasal drip.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-12
- 2021-12-19
- 2021-12-26
- 2022-02-13
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2022-05-09
Dose 4 — Moderna
- 2022-05-09
- 2022-05-10
- 2022-05-11
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2022-05-12
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2022-05-13
- 2022-05-14
- 2022-05-15
- 2022-05-16
- 2022-05-23
- 2022-05-30
- 2022-06-06
- 2022-06-13
- 2022-06-20
- 2022-08-08
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2022-09-22
Dose 5 — ModernaCo-administered: Flu
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2022-09-25
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
- 2022-09-26
- 2022-09-27
- 2022-09-28
- 2022-09-29
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-10-28
- 2022-11-06
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2022-12-22
Survey response — 3 months, dose 5MedDRA: Asthenia, COVID-19, Cough, Fatigue, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Fair · 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: Covid-19 positive with fever, body aches, cough congestion severe fatigue for 8 days, negative on days 10&11. Still congested & coughing today, stamina at 85%MedDRA releases: 2024-11 · check-in free text available
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2022-12-22
Report sent to call center — 3 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-12-23
Call successfulParticipant prefers to complete VAERS report online
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2023-03-24
Survey response — 6 months, dose 5MedDRA: COVID-19, Seasonal allergy — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-28 | Moderna | |
| 3 | 2021-11-14 | Moderna | No |
| 4 | 2022-05-09 | Moderna | No |
| 5 | 2022-09-22 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-22 | Successful 2022-12-23 |
Participant prefers to complete VAERS report online |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Rash on my face, roughly following the sinuses. Less red than yesterday. No itch
Systemic reaction (other): Face rash nearly gone
Release 10 — day 14, dose 3
Symptoms: Either severe allergy or head cold, started yesterday.
Release 10 — day 21, dose 3
Symptoms: Head cold for the 8th day; preceded with a scratchy then sore throat for 24 hours. Antihistamines help nasal drip.
Release 12 — 3 months, dose 5
Symptoms: Covid-19 positive with fever, body aches, cough congestion severe fatigue for 8 days, negative on days 10&11. Still congested & coughing today, stamina at 85%
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 | Asthenia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Seasonal allergy | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Sinus disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release