Z4K-18347-60104
4 vaccinations
6 coded responses
36 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 983 / WA
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-16
Registered in v-safe
-
2021-01-16
Dose 1 — Moderna
-
2021-01-16
Survey response — day 0, dose 1MedDRA: Blood glucose decreased, Diabetes mellitus — Feeling: GoodFree text: Type II diabetes. My sugar went from 118 following lunch .@11:15 plus a banana down to 59 by 3:00. Ate fruit, drank juice and are gummy bears. Blood sugar now at 108 and steady @4:00, normal. Ill continue to monitor closely following dinner.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Decreased insulin requirement, Pre-existing disease, Therapeutic response unexpected — Feeling: GoodFree text: Blood sugars seem to have stabilized. The vaccine appears to work as insulin keeping my blood sugars in range. My blood sugar was 84 this am and at 98 following lunch @ noon. I havent taken insulin since last nite (Lantus 15 units). Ill keep monitoring as this is great !MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease, Unevaluable event — Feeling: GoodFree text: I think Ive got the diabetes meds solved. I just take less. Seems to work.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-19
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-30
- 2021-02-06
- 2021-02-13
-
2021-02-15
Dose 2 — Moderna
-
2021-02-15
Survey response — day 0, dose 2MedDRA: Immunisation, No adverse event — Feeling: GoodFree text: Blood sugar is check. No highs nor lows as with 1st vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-05-17
- 2021-08-16
-
2021-08-17
Dose 3 — Moderna
- 2021-11-16
-
2022-02-02
Dose 4 — Moderna
- 2022-02-15
-
2022-02-15
Survey response — day 7, dose 4MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2022-02-16
- 2022-02-23
- 2022-03-02
-
2022-03-09
Survey response — day 35, dose 4MedDRA: Fall, Muscle strain — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Fell going downstairs. Strained right quadricep. No surgery nor pain medication necessary.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-09
Report sent to call center — day 35, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2022-03-10
-
2022-03-10
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-16
- 2022-05-04
- 2022-08-03
- 2023-02-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-15 | Moderna | |
| 3 | 2021-08-17 | Moderna | No |
| 4 | 2022-02-02 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-09 | Successful 2022-03-10 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): Type II diabetes. My sugar went from 118 following lunch .@11:15 plus a banana down to 59 by 3:00. Ate fruit, drank juice and are gummy bears. Blood sugar now at 108 and steady @4:00, normal. Ill continue to monitor closely following dinner.
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Blood sugars seem to have stabilized. The vaccine appears to work as insulin keeping my blood sugars in range. My blood sugar was 84 this am and at 98 following lunch @ noon. I havent taken insulin since last nite (Lantus 15 units). Ill keep monitoring as this is great !
Systemic reaction (other): I think Ive got the diabetes meds solved. I just take less. Seems to work.
Release 4 — day 0, dose 2
Systemic reaction (other): Blood sugar is check. No highs nor lows as with 1st vaccination.
Release 11 — day 7, dose 4
Systemic reaction (other): No
Release 11 — day 35, dose 4
Symptoms: Fell going downstairs. Strained right quadricep. No surgery nor pain medication necessary.
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 | Fall | · | · | ✓ |
| SD | Muscle strain | · | · | ✓ |
| SRO | Blood glucose decreased | ✓ | ✓ | ✓ |
| SRO | Decreased insulin requirement | ✓ | ✓ | ✓ |
| SRO | Diabetes mellitus | ✓ | ✓ | ✓ |
| SRO | Immunisation | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Therapeutic response unexpected | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ○ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release