Z4A-20191-25371
5 vaccinations
7 coded responses
49 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 627 / IL
- Registered
- 2021-02-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-01
Registered in v-safe
-
2021-02-01
Dose 1 — Moderna
- 2021-02-01
-
2021-02-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
-
2021-02-15
Survey response — day 14, dose 1MedDRA: Injection site erythema — Feeling: GoodFree text: Initial redness at injection site went away in two days. Now for the past two days a much larger area on my arm is red, About 2 x 3.There is noTenderness or swelling or heat feltMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-22
-
2021-03-01
Dose 2 — Moderna
- 2021-03-01
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Light headedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
-
2021-03-08
Health check-in — day 7, dose 2Feeling: Fair · Abdominal pain · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
-
2021-03-08
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-04-12
- 2021-05-31
- 2021-08-30
-
2021-10-27
Dose 3 — Moderna
- 2021-10-27
- 2021-10-28
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-11
- 2021-11-17
- 2021-11-24
- 2021-11-30
-
2021-11-30
Call successfulDoes not wish to fill out VAERS report
-
2021-12-01
Survey response — day 35, dose 3MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activitiesFree text: DiarrheaMedDRA releases: 2024-11 · check-in free text available
- 2021-12-08
-
2022-01-26
Survey response — 3 months, dose 3MedDRA: Irritable bowel syndrome, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Flare up is IBSMedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-27
-
2022-04-06
Dose 4 — Moderna
- 2022-04-18
- 2022-04-20
-
2022-04-27
Survey response — day 21, dose 4MedDRA: Erythema, Pruritus, Self-medication — Feeling: GoodFree text: Redness and itching, both sides of abdomen just below the waist line. Hydrocortisone Ointment relieves symptoms. I had not reported this earlier but now remember that I had it after both shot #2 and #3, lasting 1-3 months.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-07-06
-
2022-10-05
Survey response — 6 months, dose 4MedDRA: Brain fog, Fatigue — Feeling: GoodFree text: Intermittent brain fog and frequent tirednessMedDRA releases: 2024-11 · check-in free text available
-
2022-10-17
Dose 5 — Moderna
-
2023-04-06
Survey response — 12 months, dose 4MedDRA: Irritable bowel syndrome, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-04-06
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-04-07
- 2023-04-07
- 2023-04-11
- 2023-04-11
-
2023-04-13
Call successfulNot applicable - Accidental Reporting
-
2023-04-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-04-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-01 | Moderna | |
| 2 | 2021-03-01 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-06 | Moderna | No |
| 5 | 2022-10-17 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-08 | Successful 2021-11-30 |
Does not wish to fill out VAERS report |
| 2022-01-26 | Successful 2023-04-13 |
Not applicable - Accidental Reporting |
| 2023-04-06 | Successful 2023-04-13 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 4 — day 14, dose 1
Symptoms: Initial redness at injection site went away in two days. Now for the past two days a much larger area on my arm is red, About 2 x 3.There is noTenderness or swelling or heat felt
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Light headed
Release 10 — day 35, dose 3
Symptoms: Diarrhea
Release 11 — 3 months, dose 3
Symptoms: Flare up is IBS
Release 11 — day 21, dose 4
Symptoms: Redness and itching, both sides of abdomen just below the waist line. Hydrocortisone Ointment relieves symptoms. I had not reported this earlier but now remember that I had it after both shot #2 and #3, lasting 1-3 months.
Release 12 — 6 months, dose 4
Symptoms: Intermittent brain fog and frequent tiredness
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 | Brain fog | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Erythema | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Irritable bowel syndrome | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release