Z6T-32863-05385
4 vaccinations
2 coded responses
37 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 200 / DC
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
TVV-67155-00495
Child or adolescent in my care · Female · 2022-07-11
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
- 2021-01-21
-
2021-01-22
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-01-23
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I tested positive for covid on Saturday (received results tonight)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-25
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-01-30
Survey response — day 7, dose 1MedDRA: COVID-19, SARS-CoV-2 test positive — Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: I have Covid-19 I tested positive two days after vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
- 2021-02-11
- 2021-02-18
-
2021-02-19
Dose 2 — Moderna
-
2021-02-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-05-21
- 2021-06-03
- 2021-08-22
-
2021-11-13
Dose 3 — Moderna
- 2022-02-19
- 2022-05-14
-
2022-09-16
Dose 4 — Moderna
-
2022-09-17
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-25
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-12-16
- 2023-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-19 | Moderna | |
| 3 | 2021-11-13 | Moderna | No |
| 4 | 2022-09-16 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-25 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): I tested positive for covid on Saturday (received results tonight)
Release 3 — day 7, dose 1
Systemic reaction (other): I have Covid-19 I tested positive two days after vaccine
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 |
|---|---|---|---|---|
| SRO | COVID-19 | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release