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Z92-50111-81097

2 vaccinations 2 coded responses 18 check-ins 2 free-text entries 2 call cases
Sex
Female
Age at first dose
41-45
ZIP prefix
172 / PA
Registered
2021-01-06
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-04
    Dose 1 — Moderna
  2. 2021-01-06
    Registered in v-safe
  3. 2021-01-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work
    Adult check-in
  4. 2021-01-06
  5. 2021-01-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  6. 2021-01-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache
    Adult check-in
  7. 2021-01-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-11
    Health check-in — day 7, dose 1
    Feeling: Good · Headache
    Adult check-in
  9. 2021-01-27
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-02
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-05
    Dose 2 — Moderna
  12. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Headache
    Adult check-in
  13. 2021-02-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache
    Adult check-in
  14. 2021-02-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache, Diarrhea
    Adult check-in
  15. 2021-02-12
    Health check-in — day 7, dose 2
    Feeling: Fair · Headache
    Adult check-in
  16. 2021-02-27
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-03-07
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-13
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-03-19
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-05-08
    Survey response — 3 months, dose 2
    MedDRA: Cough, Headache, Influenza like illness, Influenza virus test negative, Malaise, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to work
    Free text: Had an influenza like illness with sore throat, headache, cough, malaise fever 99.5-101.5 for 4 days about 3 weeks ago. COVID PCR negative on day 2 of symptoms, Flu negative on day 4 of symptoms. Back to baseline on day15. Of work as PC PA-C for 4 dy
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-08-08
    Survey response — 6 months, dose 2
    MedDRA: Chills, Cough, Headache, Influenza virus test negative, Myalgia, Office visit, Pyrexia, SARS-CoV-2 test negative — 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 visit
    Free text: PC PA-C- May/21 ILI with abrupt fever, cough, chills, headache, myalgia that came on over a 6 hr period. COVID-19 negative on day 2. urgent care REFUSED to do an influenza or respiratory panel. Repeat COVID day 5 neg and flu neg. 21 d to baseline
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  22. 2021-08-08
    Report sent to call center — 6 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    1 call case(s)
  23. 2021-08-11
  24. 2022-02-06
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-04Moderna
22021-02-05Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-01-06 priority 2/3
2021-08-08 Unsuccessful

Free text

Release 8 — 3 months, dose 2

2021-05-08

Symptoms: Had an influenza like illness with sore throat, headache, cough, malaise fever 99.5-101.5 for 4 days about 3 weeks ago. COVID PCR negative on day 2 of symptoms, Flu negative on day 4 of symptoms. Back to baseline on day15. Of work as PC PA-C for 4 dy cut off by CDC

Release 9 — 6 months, dose 2

2021-08-08

Symptoms: PC PA-C- May/21 ILI with abrupt fever, cough, chills, headache, myalgia that came on over a 6 hr period. COVID-19 negative on day 2. urgent care REFUSED to do an influenza or respiratory panel. Repeat COVID day 5 neg and flu neg. 21 d to baseline

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
SDChills ✓ · ✓
SDCough ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDInfluenza like illness ✓ ✓ ✓
SDInfluenza virus test negative ✓ ✓ ✓
SDMalaise ✓ ✓ ✓
SDMyalgia ✓ · ✓
SDOffice visit ✓ · ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓

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