Z5S-32387-82306
2 vaccinations
4 coded responses
19 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 743 / OK
- Registered
- 2021-02-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-19
Registered in v-safe
-
2021-02-19
Dose 1 — Moderna
- 2021-02-19
-
2021-02-20
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-21
- 2021-02-22
-
2021-02-23
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Myalgia — Feeling: Good · Site: Pain · Muscle or body achesFree text: Muscle soreness and pain within inner upper arm that I received the shot in.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-03-05
-
2021-03-12
Survey response — day 21, dose 1MedDRA: Headache, Office visit, Wound — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sore on head.still sore and saw the Dr 2 weeks ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-19
Dose 2 — Moderna
- 2021-03-26
- 2021-04-02
-
2021-04-09
Survey response — day 21, dose 2MedDRA: Fatigue — Feeling: GoodFree text: I have felt more tired thn usualMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-06-18
- 2021-09-17
- 2021-12-08
-
2022-03-19
Survey response — 12 months, dose 2MedDRA: Acne, Dry skin, Pruritus, Rash, Self-medication — Feeling: GoodFree text: Rash, skin breakouts on arms whee I received the injections. Also on my upper back and chest which was very itchy. I started putting lots of lotion on them and they healed up. Extra dry skin around the pimple breakouts.- only 3-4 spots on each cite.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-19 | Moderna | |
| 2 | 2021-03-19 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-12 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Muscle soreness and pain within inner upper arm that I received the shot in.
Release 5 — day 21, dose 1
Symptoms: Sore on head.still sore and saw the Dr 2 weeks ago.
Release 7 — day 21, dose 2
Symptoms: I have felt more tired thn usual
Release 11 — 12 months, dose 2
Symptoms: Rash, skin breakouts on arms whee I received the injections. Also on my upper back and chest which was very itchy. I started putting lots of lotion on them and they healed up. Extra dry skin around the pimple breakouts.- only 3-4 spots on each cite. cut off by CDC
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 | Acne | · | · | ✓ |
| SD | Dry skin | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Wound | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release