Z83-85116-01591
2 vaccinations
7 coded responses
18 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 467 / IN
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Registered in v-safe
-
2021-01-26
Dose 1 — Moderna
- 2021-01-26
-
2021-01-27
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Muscle or body achesFree text: The only muscle is the arm in which I got the injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
-
2021-01-29
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Fatigue or tirednessFree text: No big deal it is Friday and the week has been long and full of stressMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-30
-
2021-01-31
Survey response — days 1–6 daily, dose 1MedDRA: Depressed mood, Feeling abnormal — Feeling: Fair · Fatigue or tirednessFree text: Just feel blah / dumpyProbably has nothing to do with injection just lifeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-01
-
2021-02-02
Survey response — day 7, dose 1MedDRA: Nasal congestion, Office visit, Rhinorrhoea — Feeling: FairFree text: Stuffy and runny nose Go to Dr for routine 6 mo checkup and new RXMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
- 2021-02-16
-
2021-02-23
Dose 2 — Moderna
- 2021-02-23
-
2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: Good · Site: Swelling · Headache, Fatigue or tirednessFree text: Not a big deal not really a headache just fuzzy or foggyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-02-26
- 2021-02-27
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Fatigue or tirednessFree text: Since I have had no negative reactions to date Im going to opt outIf you have further questions dont hesitate to contact meMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-24
-
2022-02-23
Survey response — 12 months, dose 2MedDRA: Bronchitis, Office visit — Feeling: Poor · Get care from a doctor or other healthcare professionalFree text: Symptoms: I simply have my semi annual bronchitis I went to Dr yesterday and got some RX · Healthcare visit (other): Family physicianMedDRA releases: 2024-11 · check-in free text available
-
2022-02-23
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2022-02-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-23 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-23 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): The only muscle is the arm in which I got the injection
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): No big deal it is Friday and the week has been long and full of stress
Systemic reaction (other): Just feel blah / dumpyProbably has nothing to do with injection just life
Release 3 — day 7, dose 1
Systemic reaction (other): Stuffy and runny nose Go to Dr for routine 6 mo checkup and new RX
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Not a big deal not really a headache just fuzzy or foggy
Systemic reaction (other): Since I have had no negative reactions to date Im going to opt outIf you have further questions dont hesitate to contact me
Release 11 — 12 months, dose 2
Symptoms: I simply have my semi annual bronchitis I went to Dr yesterday and got some RX
Healthcare visit (other): Family physician
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SRO | Depressed mood | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Office visit | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release