Z7E-26589-80740
2 vaccinations
2 coded responses
2 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 922 / CA
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Dose 1 — Moderna
-
2021-03-10
Registered in v-safe
-
2021-03-10
Dose 2 — Moderna
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Atrial fibrillation, Chills, Headache, Nausea, Pain — Feeling: GoodFree text: For 30 hours after my vaccine, I had a 100° fever, chills, headache, nausea, and body aches. I went in and out of a fib, the longest event lasting seven hours. On day three, I had no symptoms and was able to resume my normal activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-09-08
Survey response — 6 months, dose 2MedDRA: Exposure to SARS-CoV-2, Pyrexia, Quarantine, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: My husband positive for Covid on Sunday. I tested negative. I had a low-grade fever for four days. Because of my husbands diagnosis, we are quarantining for 10 days.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-08
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-14
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | |
| 2 | 2021-03-10 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-09-08 | Successful 2021-09-14 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): For 30 hours after my vaccine, I had a 100° fever, chills, headache, nausea, and body aches. I went in and out of a fib, the longest event lasting seven hours. On day three, I had no symptoms and was able to resume my normal activities
Release 9 — 6 months, dose 2
Symptoms: My husband positive for Covid on Sunday. I tested negative. I had a low-grade fever for four days. Because of my husbands diagnosis, we are quarantining for 10 days.
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 | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Quarantine | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Atrial fibrillation | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release