Z4S-18134-48500
3 vaccinations
3 coded responses
23 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 300 / GA
- Registered
- 2021-04-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-23
Dose 1 — Moderna
-
2021-04-20
Dose 2 — Moderna
-
2021-04-22
Registered in v-safe
-
2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I want to mention that today is my third day after the shot. The first day was difficult and the second day as well. Today I feel betterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I get bad symptoms at night. During the day, I feel tired but not many symptoms. However, at night the symptoms come and are limiting.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-04-27
Health check-in — day 7, dose 2Feeling: Good · Site: Pain, Redness, Itching · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-05-05
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-07-20
- 2021-10-19
-
2021-10-27
Dose 3 — ModernaCo-administered: Flu
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Itching · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Itching · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-11-05
- 2021-11-12
- 2021-11-17
- 2021-11-24
- 2021-12-11
-
2022-01-28
Survey response — 3 months, dose 3MedDRA: Medical counselling, Rash, Reaction to previous exposure to any vaccine, Upper respiratory tract infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Upper respiratory infection on 12/28/2021. Symptoms included the same rash (whole body) that I had during COVID's second shot and booster. However, rapid tests were negative (tested twice). · Healthcare visit (other): Phone callMedDRA releases: 2024-11 · check-in free text available
-
2022-01-28
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2022-01-31
-
2022-01-31
Call successfulDoes not wish to fill out VAERS report
- 2022-04-27
- 2022-10-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-23 | Moderna | |
| 2 | 2021-04-20 | Moderna | |
| 3 | 2021-10-27 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-23 | Successful | Does not wish to fill out VAERS report |
| 2022-01-28 | Successful 2022-01-31 |
Does not wish to fill out VAERS report |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I want to mention that today is my third day after the shot. The first day was difficult and the second day as well. Today I feel better
Systemic reaction (other): I get bad symptoms at night. During the day, I feel tired but not many symptoms. However, at night the symptoms come and are limiting.
Release 11 — 3 months, dose 3
Symptoms: Upper respiratory infection on 12/28/2021. Symptoms included the same rash (whole body) that I had during COVID's second shot and booster. However, rapid tests were negative (tested twice).
Healthcare visit (other): Phone call
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 | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release