Z73-21837-13485
3 vaccinations
2 coded responses
16 check-ins
2 free-text entries
2 call cases
- Sex
- —
- Age at first dose
- 26-30
- ZIP prefix
- 524 / IA
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Dose 1 — Moderna
-
2021-01-05
Registered in v-safe
-
2021-01-05
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-06
- 2021-01-15
-
2021-02-03
Dose 2 — Moderna
-
2021-02-03
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body achesAdult check-in
-
2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-02-07
- 2021-02-08
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-02-10
- 2021-02-19
- 2021-08-04
-
2021-11-03
Dose 3 — Moderna
-
2021-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Dermatitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Dermatitis of the arms and torsoMedDRA releases: 2024-11 · check-in free text available
-
2021-11-06
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-11-07
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-11-08
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
-
2021-11-08
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-10
-
2022-02-02
Survey response — 3 months, dose 3MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Tested positive for covid.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-02-03 | Moderna | |
| 3 | 2021-11-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-06 | Unsuccessful | |
| 2021-11-08 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Dermatitis of the arms and torso
Release 11 — 3 months, dose 3
Symptoms: Tested positive for covid.
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 | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Dermatitis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release