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Z7J-28537-14526

1 vaccination 6 coded responses 11 check-ins 6 free-text entries 2 call cases
Sex
Female
Age at first dose
31-35
ZIP prefix
547 / WI
Registered
2021-04-27
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-27
    Registered in v-safe
  2. 2021-04-27
    Dose 1 — Moderna
  3. 2021-04-27
    Health check-in — day 0, dose 1
    Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  4. 2021-04-28
    Survey response — days 1–6 daily, dose 1
    MedDRA: Asthma, Cough, Somnolence — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work
    Free text: Asthma is acting up, coughing this morning a lot. I literally slept all day.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-29
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-04-30
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-05-01
    Survey response — days 1–6 daily, dose 1
    MedDRA: Asthma, Feeling hot, Pre-existing disease — Feeling: Good · Fever
    Free text: I just feel hot and my asthma has been acting up, but not anything bad
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-05-03
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pre-existing disease, Rash — Feeling: Good · Headache, Rash, not including the immediate area around the injection site
    Free text: I have eczema so pretty sure rash is from that
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-05-04
    Survey response — day 7, dose 1
    MedDRA: Asthma, Pre-existing disease — Feeling: Good · Headache, Rash, not including the immediate area around the injection site
    Free text: Asthma is still acting up
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-11
    Survey response — day 14, dose 1
    MedDRA: Anaphylactic shock, Injection site mass, Self-medication, Urticaria — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit
    Free text: On day 8 I developed a lump at the injection site and the a giant hive, and then about an hour and a half later I had anaphylaxis shock. I am still experiencing this since last Wednesday, I have to be on 60 prednisone and maxed out benedryl & pepcid
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-05-11
    Report sent to call center — day 14, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  12. 2021-05-18
    Survey response — day 21, dose 1
    MedDRA: Blood pressure increased, Emergency care, Hypersensitivity — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: I'm still on prednisone for the allergic reaction and today my blood pressure sky rocketed and I had to go in to the ER. The doctors think its the prednisone.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-05-18
    Report sent to call center — day 21, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  14. 2021-05-27
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  15. 2021-07-27
    Health check-in — 3 months, dose 1
    Feeling: Fair
    Adult check-in
  16. 2022-01-05

Vaccinations

DoseDateManufacturerCo-administered
12021-04-27Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-05-11 Unsuccessful
2021-05-18 Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 1

2021-04-28

Systemic reaction (other): Asthma is acting up, coughing this morning a lot. I literally slept all day.

2021-05-01

Systemic reaction (other): I just feel hot and my asthma has been acting up, but not anything bad

2021-05-03

Systemic reaction (other): I have eczema so pretty sure rash is from that

Release 8 — day 7, dose 1

2021-05-04

Systemic reaction (other): Asthma is still acting up

Release 8 — day 14, dose 1

2021-05-11

Symptoms: On day 8 I developed a lump at the injection site and the a giant hive, and then about an hour and a half later I had anaphylaxis shock. I am still experiencing this since last Wednesday, I have to be on 60 prednisone and maxed out benedryl & pepcid cut off by CDC

Release 8 — day 21, dose 1

2021-05-18

Symptoms: I'm still on prednisone for the allergic reaction and today my blood pressure sky rocketed and I had to go in to the ER. The doctors think its the prednisone.

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

FieldPreferred term2021-092023-042024-11
SDAnaphylactic shock ✓ ✓ ✓
SDBlood pressure increased ✓ ✓ ✓
SDEmergency care ✓ ✓ ✓
SDHypersensitivity ✓ ✓ ✓
SDInjection site mass ✓ ✓ ✓
SDSelf-medication ✓ ✓ ✓
SDUrticaria ✓ ✓ ✓
SROAsthma ✓ ✓ ✓
SROCough ✓ ✓ ✓
SROFeeling hot ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SRORash ✓ ✓ ✓
SROSomnolence ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release