Z3U-31619-58822
3 vaccinations
5 coded responses
39 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 640 / MO
- Registered
- 2021-04-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Dose 1 — Moderna
-
2021-04-02
Registered in v-safe
-
2021-04-02
Survey response — days 1–6 daily, dose 1MedDRA: Herpes zoster, Office visit — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Diagnosed at urgent care with shingles yesterday I had rash day of vaccine but did not know it was shinglesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
-
2021-04-07
Survey response — day 7, dose 1MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree text: I do have shingles so it has made things rougherMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
-
2021-04-21
Survey response — day 21, dose 1MedDRA: Lymph node pain, Lymphadenopathy — Feeling: FairFree text: Its been 3 weeks today since my moderna injection today my lymph node under my armpit on that same injection side has been swollen and tender. Worried to have 2nd injection next Wed in that arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
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 · Fatigue or tirednessAdult check-in
-
2021-04-30
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
- 2021-07-28
- 2021-10-27
-
2021-11-30
Dose 3 — Moderna
-
2021-11-30
Health check-in — day 0, dose 3Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tirednessAdult check-in
-
2021-12-01
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body achesAdult check-in
-
2021-12-02
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Muscle or body achesAdult check-in
- 2021-12-03
- 2021-12-04
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-01-04
-
2022-01-11
Survey response — day 42, dose 3MedDRA: Dysphonia, Oropharyngeal pain, Paranasal sinus hypersecretion — Feeling: PoorFree text: Sinus drainage and hoarseness throat little soreMedDRA releases: 2024-11 · check-in free text available
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2022-03-01
Survey response — 3 months, dose 3MedDRA: Office visit, Sinusitis — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professionalFree text: Symptoms: Terrible sinus infection had to go on prednisone and antibiotics. · Healthcare visit (other): Had appt at officeMedDRA releases: 2024-11 · check-in free text available
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2022-03-01
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-03-03
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-05-31
- 2022-11-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-28 | Moderna | |
| 3 | 2021-11-30 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-01 | Successful 2022-03-03 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Diagnosed at urgent care with shingles yesterday I had rash day of vaccine but did not know it was shingles
Release 7 — day 7, dose 1
Systemic reaction (other): I do have shingles so it has made things rougher
Release 7 — day 21, dose 1
Symptoms: Its been 3 weeks today since my moderna injection today my lymph node under my armpit on that same injection side has been swollen and tender. Worried to have 2nd injection next Wed in that arm.
Release 10 — day 42, dose 3
Symptoms: Sinus drainage and hoarseness throat little sore
Release 11 — 3 months, dose 3
Symptoms: Terrible sinus infection had to go on prednisone and antibiotics.
Healthcare visit (other): Had appt at office
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 | Office visit | · | · | ✓ |
| SD | Dysphonia | · | · | ✓ |
| SD | Lymph node pain | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Herpes zoster | ✓ | ✓ | ✓ |
| SRO | Office visit | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release