Z8W-21000-27512
3 vaccinations
9 coded responses
31 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 275 / NC
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-18
Registered in v-safe
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2021-03-18
Dose 1 — Moderna
- 2021-03-18
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2021-03-19
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-27
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2021-04-03
Survey response — day 14, dose 1MedDRA: Pain in extremity, Tenderness — Feeling: GoodFree text: On the 2 week mark of receiving my first shot my arm was sore again. Only for the day and not as sore but more tender as when I got the shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-08
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2021-04-13
Dose 2 — Moderna
- 2021-04-13
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2021-04-14
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Dysgeusia — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Metal tasteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
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2021-04-27
Survey response — day 14, dose 2MedDRA: Respiratory rate decreased, Syncope — Feeling: GoodFree text: Ive caught myself not breathing as deeply as I need to and feeling very faint. Once I notice this faint feeling, Ill take a deep breath and then Im ok again. Has happened 2 -3 times this past week. Will continue to monitorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-04
Survey response — day 21, dose 2MedDRA: Urticaria — Feeling: GoodFree text: Have really reacted to gnat bites which I never have in the previous years! Spent a nice evening on our deck and received several bites that became inflamed and developed into welts by morning. Have kept me up during the night from itching so badMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-12
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2021-05-19
Survey response — day 35, dose 2MedDRA: Exercise tolerance decreased, Myalgia — Feeling: GoodFree text: Sore muscles in my legs. I do walk daily but have noticed my muscles are sore and not healing as quicklyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-26
Survey response — day 42, dose 2MedDRA: Adverse reaction — Feeling: GoodFree text: Still reacting to mosquito bitesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-13
- 2021-10-14
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2022-04-15
Survey response — 12 months, dose 2MedDRA: Fatigue, Influenza like illness, Office visit, Pyrexia, SARS-CoV-2 test positive, Self-medication — Feeling: Good · Be unable to work or attend school, 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: Symptoms: I tested positive for Covid Jan 18 2022. Had flu like symptoms with fever for a few hours then very tired for 5 days. Took cold medicine to get through it all. · Healthcare visit (other): Doctors office visitMedDRA releases: 2024-11 · check-in free text available
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2022-04-15
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-04-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-10-14
Dose 3 — Moderna
- 2022-10-22
- 2022-10-30
- 2022-11-04
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2022-11-18
Survey response — day 35, dose 3MedDRA: Arthralgia, Myalgia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Muscles and joints in elbow are sore on both arms. Haven't don't anything different to have sore armsMedDRA releases: 2024-11 · check-in free text available
- 2022-11-25
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2023-01-13
Survey response — 3 months, dose 3MedDRA: Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-01-13
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2023-01-17
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-13 | Moderna | |
| 3 | 2022-10-14 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-15 | Successful 2022-04-20 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-01-13 | Successful 2023-01-17 |
Participant prefers to complete VAERS report online |
Free text
Release 6 — day 14, dose 1
Symptoms: On the 2 week mark of receiving my first shot my arm was sore again. Only for the day and not as sore but more tender as when I got the shot
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Metal taste
Release 8 — day 14, dose 2
Symptoms: Ive caught myself not breathing as deeply as I need to and feeling very faint. Once I notice this faint feeling, Ill take a deep breath and then Im ok again. Has happened 2 -3 times this past week. Will continue to monitor
Release 8 — day 21, dose 2
Symptoms: Have really reacted to gnat bites which I never have in the previous years! Spent a nice evening on our deck and received several bites that became inflamed and developed into welts by morning. Have kept me up during the night from itching so bad
Release 8 — day 35, dose 2
Symptoms: Sore muscles in my legs. I do walk daily but have noticed my muscles are sore and not healing as quickly
Release 8 — day 42, dose 2
Symptoms: Still reacting to mosquito bites
Release 11 — 12 months, dose 2
Symptoms: I tested positive for Covid Jan 18 2022. Had flu like symptoms with fever for a few hours then very tired for 5 days. Took cold medicine to get through it all.
Healthcare visit (other): Doctors office visit
Release 12 — day 35, dose 3
Symptoms: Muscles and joints in elbow are sore on both arms. Haven't don't anything different to have sore arms
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 | Adverse reaction | ✓ | ✓ | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Exercise tolerance decreased | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory rate decreased | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Syncope | ✓ | ✓ | ✓ |
| SD | Tenderness | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release