Z69-27530-43977
5 vaccinations
12 coded responses
45 check-ins
11 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 945 / CA
- Registered
- 2021-01-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
DZK-26261-03525
Adult relative or friend · Male · 2022-04-15
Timeline
-
2021-01-26
Dose 1 — Moderna
-
2021-01-27
Registered in v-safe
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
-
2021-02-02
Survey response — day 7, dose 1MedDRA: Blepharitis — Feeling: GoodFree text: BlepharitisMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
- 2021-02-16
-
2021-02-23
Dose 2 — Moderna
- 2021-02-23
-
2021-02-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Fatigue — Feeling: Good · Site: Pain, Redness, Swelling · Chills, Fatigue or tirednessFree text: Chills, and fatigue were last night, but I felt fine this morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Cough, Upper-airway cough syndrome — Feeling: Good · Site: Redness, Swelling, ItchingFree text: Cough from mucus draining into throat.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body achesAdult check-in
- 2021-03-01
- 2021-03-02
-
2021-03-09
Survey response — day 14, dose 2MedDRA: Cough, Sinus operation — Feeling: GoodFree text: Constant drainage down back of throat resulting in cough.Have had it for a while and it gets worse and then better.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — day 21, dose 2MedDRA: Sinus disorder — Feeling: GoodFree text: Mucus from my sinuses draining down the back of my throat. My husband has started doing that too and he had Pfizer.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-23
Survey response — day 28, dose 2MedDRA: Myalgia, Pain in extremity — Feeling: GoodFree text: Sore upper arm muscles, especially in the left arm in which I had gotten my vaccine. How ever I am out of shape and have been packing to move so I didnt bring this up earlier.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-30
- 2021-04-06
- 2021-05-25
- 2021-08-24
-
2021-11-14
Dose 3 — Moderna
-
2021-11-18
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-19
- 2021-11-20
- 2021-11-21
- 2021-11-28
-
2021-12-05
Survey response — day 21, dose 3MedDRA: Cardiac flutter, Fatigue — Feeling: FairFree text: Fluttery inside my chest. Tired.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-13
- 2021-12-19
-
2021-12-26
Survey response — day 42, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: FairFree text: I've had chronic sinus inflammation for over a year but today it seems more inflamed.MedDRA releases: 2024-11 · check-in free text available
- 2022-02-13
-
2022-04-12
Dose 4 — Moderna
-
2022-04-15
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-04-17
-
2022-04-18
Survey response — days 1–6 daily, dose 4MedDRA: Oropharyngeal pain, Pharyngeal swelling — Feeling: Good · Abdominal painFree text: Left side of throat was a little sore and slightly swollen but it's better now.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-19
- 2022-04-29
-
2022-05-03
Survey response — day 21, dose 4MedDRA: Induration, Pain, Pain in extremity — Feeling: GoodFree text: My left arm has been hurting for several months but I ignored it. However it is a burning pain in places when I touch it hard. The pain has gradually moved from my upper arm to my lower arm. X-ray showed nothing.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-10
- 2022-05-17
-
2022-05-26
Survey response — day 42, dose 4MedDRA: Medical counselling, Musculoskeletal pain, Pain, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Left shoulder blade area has sharp, shooting pain and hurts too much to move my body. Left arm has had weird pains for months. Left arm is the site of my Covid vaccine shots. · Healthcare visit (other): I called therapist who referred me to massage therapist,MedDRA releases: 2024-11 · check-in free text available
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2022-05-26
Report sent to call center — day 42, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-05-27
-
2022-05-27
Call successfulNot applicable - Accidental Reporting
- 2022-07-13
- 2022-10-13
-
2022-11-15
Dose 5 — Moderna
-
2023-05-16
Survey response — 6 months, dose 5MedDRA: Arteriosclerosis, Blindness unilateral, Hyperbaric oxygen therapy, Malaise — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
-
2023-05-16
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2023-05-17
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-23 | Moderna | |
| 3 | 2021-11-14 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
| 5 | 2022-11-15 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-26 | Successful 2022-05-27 |
Not applicable - Accidental Reporting |
| 2023-05-16 | Successful 2023-05-17 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 3 — day 7, dose 1
Systemic reaction (other): Blepharitis
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Chills, and fatigue were last night, but I felt fine this morning
Systemic reaction (other): Cough from mucus draining into throat.
Release 5 — day 14, dose 2
Symptoms: Constant drainage down back of throat resulting in cough.Have had it for a while and it gets worse and then better.
Release 5 — day 21, dose 2
Symptoms: Mucus from my sinuses draining down the back of my throat. My husband has started doing that too and he had Pfizer.
Release 6 — day 28, dose 2
Symptoms: Sore upper arm muscles, especially in the left arm in which I had gotten my vaccine. How ever I am out of shape and have been packing to move so I didnt bring this up earlier.
Release 10 — day 21, dose 3
Symptoms: Fluttery inside my chest. Tired.
Release 10 — day 42, dose 3
Symptoms: I've had chronic sinus inflammation for over a year but today it seems more inflamed.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Left side of throat was a little sore and slightly swollen but it's better now.
Release 11 — day 21, dose 4
Symptoms: My left arm has been hurting for several months but I ignored it. However it is a burning pain in places when I touch it hard. The pain has gradually moved from my upper arm to my lower arm. X-ray showed nothing.
Release 11 — day 42, dose 4
Symptoms: Left shoulder blade area has sharp, shooting pain and hurts too much to move my body. Left arm has had weird pains for months. Left arm is the site of my Covid vaccine shots.
Healthcare visit (other): I called therapist who referred me to massage therapist,
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 | Hyperbaric oxygen therapy | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| SD | Arteriosclerosis | · | · | ✓ |
| SD | Blindness unilateral | · | · | ✓ |
| SD | Cardiac flutter | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Induration | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Musculoskeletal pain | · | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Sinus disorder | ✓ | ✓ | ✓ |
| SD | Sinus operation | ✓ | ✓ | ✓ |
| SRO | Blepharitis | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Pharyngeal swelling | · | · | ✓ |
| SRO | Upper-airway cough syndrome | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release