Z6M-33047-04573
5 vaccinations
9 coded responses
37 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 786 / TX
- Registered
- 2021-01-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-02
Registered in v-safe
-
2021-01-02
Dose 1 — Moderna
- 2021-01-02
-
2021-01-03
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-01-04
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fever · Fatigue or tiredness, Nausea, Abdominal painAdult check-in
- 2021-01-05
-
2021-01-06
Survey response — days 1–6 daily, dose 1MedDRA: Sinus congestion — Feeling: GoodFree text: Feels like sinus congestion - mildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-16
- 2021-01-23
-
2021-01-27
Dose 2 — Moderna
-
2021-01-28
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal, Rhinorrhoea — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Runny nose foggynessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-29
Survey response — days 1–6 daily, dose 2MedDRA: Lacrimation increased, Pyrexia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Watery eyes, feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
-
2021-02-10
Survey response — day 14, dose 2MedDRA: Dizziness — Feeling: GoodFree text: Dizziness/light headednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-02-26
- 2021-03-03
- 2021-03-12
- 2021-04-30
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2021-07-28
Survey response — 6 months, dose 2MedDRA: Cough, Fatigue, Headache, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activitiesFree text: Bad cold - headache, cough, sore throat, runny nose, fatigue. I did not get tested as there are no longer local test sites available.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-30
Dose 3 — Moderna
-
2022-01-27
Survey response — 12 months, dose 2MedDRA: Chest pain, Chills, Headache, Myalgia, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: Sore throat, head and muscle ache, chills, chest painMedDRA releases: 2024-11 · check-in free text available
-
2022-04-03
Dose 4 — Moderna
- 2022-04-26
- 2022-05-01
- 2022-05-09
- 2022-05-15
- 2022-07-03
-
2022-09-15
Dose 5 — Moderna
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2022-10-02
Survey response — 6 months, dose 4MedDRA: Exposure to SARS-CoV-2, Fatigue, Gastrointestinal disorder, Headache, Pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activitiesFree text: I've had a couple bouts of symptoms of covid (after exposure) but always tested negative. Headache, fever, aches, fatigue, stomach issues...MedDRA releases: 2024-11 · check-in free text available
- 2022-10-08
-
2022-10-13
Survey response — day 28, dose 5MedDRA: Abdominal distension, Feeling abnormal, Flatulence — Feeling: GoodFree text: Gastro - bloating, gas... Fuzzy head ??MedDRA releases: 2024-11 · check-in free text available
- 2022-10-22
- 2022-10-31
- 2022-12-15
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2023-03-18
Survey response — 6 months, dose 5MedDRA: Cough, Headache, Heart rate increased, Hyperhidrosis, Pain, Pyrexia, Rash, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
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2023-03-18
Report sent to call center — 6 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2023-03-21
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 | 2021-01-02 | Moderna | |
| 2 | 2021-01-27 | Moderna | |
| 3 | 2021-08-30 | Moderna | No |
| 4 | 2022-04-03 | Moderna | No |
| 5 | 2022-09-15 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-03-18 | Successful 2023-03-21 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Feels like sinus congestion - mild
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Runny nose foggyness
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Watery eyes, fever
Release 4 — day 14, dose 2
Symptoms: Dizziness/light headedness
Release 9 — 6 months, dose 2
Symptoms: Bad cold - headache, cough, sore throat, runny nose, fatigue. I did not get tested as there are no longer local test sites available.
Release 11 — 12 months, dose 2
Symptoms: Sore throat, head and muscle ache, chills, chest pain
Release 12 — 6 months, dose 4
Symptoms: I've had a couple bouts of symptoms of covid (after exposure) but always tested negative. Headache, fever, aches, fatigue, stomach issues...
Release 12 — day 28, dose 5
Symptoms: Gastro - bloating, gas... Fuzzy head ??
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 | Abdominal distension | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Feeling abnormal | · | · | ✓ |
| SD | Flatulence | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Heart rate increased | · | · | ✓ |
| SD | Hyperhidrosis | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Lacrimation increased | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Sinus congestion | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release