Z52-31049-57404
2 vaccinations
4 coded responses
15 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 439 / OH
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-16
Dose 1 — Moderna
-
2021-03-15
Dose 2 — Moderna
-
2021-03-16
Registered in v-safe
-
2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-18
Survey response — days 1–6 daily, dose 2MedDRA: Discomfort, Eye pain, Pain, Rhinalgia — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: I have a mild amount of irritable pain behind my right cheek, below my eye, and near my nose. Slight pressure that started 14 hours ago and hasnt let up or gotten worseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-19
Survey response — days 1–6 daily, dose 2MedDRA: Sinus disorder — Feeling: Fair · Site: Itching · Fatigue or tirednessFree text: Still have that feeling around my right sinus.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-21
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-06-14
-
2021-09-15
Survey response — 6 months, dose 2MedDRA: Chest discomfort, Cough, Headache, Increased upper airway secretion, Myalgia, Nasal congestion, Paranasal sinus discomfort, Respiratory tract congestion, Sneezing, Throat irritation — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Last 3 days i had real sore muscles in my legs. Today 9-15 i have headache, sinus pressure, stuffy nose, congestion, a tickle in my chest and throat. Some mucous in back of my throat. Keep sneezing and i cough every so oftenMedDRA releases: 2024-11 · check-in free text available
-
2022-03-16
Survey response — 12 months, dose 2MedDRA: COVID-19, Colitis, Fatigue, Fluid retention, Impaired work ability, Office visit, Swelling — Feeling: Fair · 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: Symptoms: Ive been retaining and barely losing up to 45 lbs of fluid with bad swelling and now i have colitis in my leg. I have bad fatigue and my blood pressure is either 170/116 or 107/70. All since getting covid a 2nd time in Sept. I also lost my job · Healthcare visit (other): My family Dr visitsMedDRA releases: 2024-11 · check-in free text available
-
2022-03-16
Report sent to call center — 12 months, dose 2Be 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)
- 2022-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-16 | Moderna | |
| 2 | 2021-03-15 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-16 | Unsuccessful |
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): I have a mild amount of irritable pain behind my right cheek, below my eye, and near my nose. Slight pressure that started 14 hours ago and hasnt let up or gotten worse
Systemic reaction (other): Still have that feeling around my right sinus.
Release 9 — 6 months, dose 2
Symptoms: Last 3 days i had real sore muscles in my legs. Today 9-15 i have headache, sinus pressure, stuffy nose, congestion, a tickle in my chest and throat. Some mucous in back of my throat. Keep sneezing and i cough every so often
Release 11 — 12 months, dose 2
Symptoms: Ive been retaining and barely losing up to 45 lbs of fluid with bad swelling and now i have colitis in my leg. I have bad fatigue and my blood pressure is either 170/116 or 107/70. All since getting covid a 2nd time in Sept. I also lost my job
Healthcare visit (other): My family Dr visits
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 | Chest discomfort | · | · | ✓ |
| SD | Colitis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Fluid retention | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Impaired work ability | · | · | ✓ |
| SD | Increased upper airway secretion | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Swelling | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Rhinalgia | ✓ | ✓ | ✓ |
| SRO | Sinus disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release