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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

  1. 2021-01-26
    Registered in v-safe
  2. 2021-01-26
    Dose 1 — Moderna
  3. 2021-01-26
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-27
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site pain — Feeling: Good · Muscle or body aches
    Free text: The only muscle is the arm in which I got the injection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-29
    Survey response — days 1–6 daily, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness
    Free text: No big deal it is Friday and the week has been long and full of stress
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-30
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-31
    Survey response — days 1–6 daily, dose 1
    MedDRA: Depressed mood, Feeling abnormal — Feeling: Fair · Fatigue or tiredness
    Free text: Just feel blah / dumpyProbably has nothing to do with injection just life
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-02
    Survey response — day 7, dose 1
    MedDRA: Nasal congestion, Office visit, Rhinorrhoea — Feeling: Fair
    Free text: Stuffy and runny nose Go to Dr for routine 6 mo checkup and new RX
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-09
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-16
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-23
    Dose 2 — Moderna
  14. 2021-02-23
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-02-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Good · Site: Swelling · Headache, Fatigue or tiredness
    Free text: Not a big deal not really a headache just fuzzy or foggy
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Swelling · None
    Adult check-in
  17. 2021-02-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-02-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness
    Free text: Since I have had no negative reactions to date Im going to opt outIf you have further questions dont hesitate to contact me
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-08-24
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2022-02-23
    Survey response — 12 months, dose 2
    MedDRA: Bronchitis, Office visit — Feeling: Poor · Get care from a doctor or other healthcare professional
    Free text: Symptoms: I simply have my semi annual bronchitis I went to Dr yesterday and got some RX · Healthcare visit (other): Family physician
    MedDRA releases: 2024-11 · check-in free text available
  22. 2022-02-23
    Report sent to call center — 12 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  23. 2022-02-24

Vaccinations

DoseDateManufacturerCo-administered
12021-01-26Moderna
22021-02-23Moderna

Call center

ReportedOutcomeVAERS-related outcome
2022-02-23 Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): The only muscle is the arm in which I got the injection

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): No big deal it is Friday and the week has been long and full of stress

2021-01-31

Systemic reaction (other): Just feel blah / dumpyProbably has nothing to do with injection just life

Release 3 — day 7, dose 1

2021-02-02

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

2021-02-24

Systemic reaction (other): Not a big deal not really a headache just fuzzy or foggy

2021-02-28

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

2022-02-23

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
SDBronchitis · · ✓
SDOffice visit · · ✓
SRODepressed mood ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SRONasal congestion ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓
SROOffice visit ✓ ✓ ✓
SRORhinorrhoea ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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