Z6W-27132-88264
5 vaccinations
7 coded responses
38 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 760 / TX
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Dose 1 — Moderna
-
2021-01-12
Registered in v-safe
-
2021-01-12
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Fair · Site: Pain · Headache, NauseaFree text: Don't eat greasey food and stay well hydratedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-13
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to workFree text: No just beibg cause of fried food and the internet saud you shouldn't consume alcohol before or after the infection so that you don't weajend your immune system 😜. Im feeling just fine today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-13
-
2021-01-14
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Sleep disorder — Feeling: GoodFree text: Very light muscle pain if I sleep on that arm or wear a bra strap on that muscle that was injected. Im not tired or bothered.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-25
- 2021-02-01
-
2021-02-08
Dose 2 — Moderna
- 2021-02-08
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, DiarrheaAdult check-in
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-13
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: Happy Valentines Day!!!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-22
-
2021-05-10
Survey response — 3 months, dose 2MedDRA: Heart rate increased — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, HospitalizationFree text: Rapid heart beatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-10
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-29
- 2021-08-09
-
2021-10-25
Dose 3 — Moderna
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-30
- 2021-11-01
- 2021-11-08
-
2022-04-22
Dose 4 — Moderna
- 2022-04-27
- 2022-05-18
- 2022-07-27
-
2022-10-23
Dose 5 — ModernaCo-administered: Flu
- 2022-10-23
- 2022-10-25
-
2022-10-28
Survey response — days 1–6 daily, dose 5MedDRA: Diarrhoea — Feeling: Good · DiarrheaFree text: I think the Diarrhea was my Pastors wife supperMedDRA releases: 2024-11 · check-in free text available
- 2022-11-01
-
2022-11-20
Survey response — day 28, dose 5MedDRA: Anxiety, Nervousness — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Some type of nerve anxietyMedDRA releases: 2024-11 · check-in free text available
-
2022-11-20
Report sent to call center — day 28, dose 5Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-11-21
- 2022-11-21
-
2022-11-21
Call successfulDoes not wish to fill out VAERS report
-
2022-11-21
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-22 | Moderna | No |
| 5 | 2022-10-23 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-13 | priority 2/3 | |
| 2021-05-10 | Successful 2022-11-21 |
Does not wish to fill out VAERS report |
| 2022-11-20 | Successful 2022-11-21 |
Does not wish to fill out VAERS report |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Don't eat greasey food and stay well hydrated
Systemic reaction (other): No just beibg cause of fried food and the internet saud you shouldn't consume alcohol before or after the infection so that you don't weajend your immune system 😜. Im feeling just fine today.
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Very light muscle pain if I sleep on that arm or wear a bra strap on that muscle that was injected. Im not tired or bothered.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Happy Valentines Day!!!
Release 8 — 3 months, dose 2
Symptoms: Rapid heart beat
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): I think the Diarrhea was my Pastors wife supper
Release 12 — day 28, dose 5
Symptoms: Some type of nerve anxiety
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 | Anxiety | · | · | ✓ |
| SD | Heart rate increased | ✓ | ✓ | ✓ |
| SD | Nervousness | · | · | ✓ |
| SRO | Diarrhoea | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release