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
-
2021-01-04
Dose 1 — Moderna
-
2021-01-06
Registered in v-safe
-
2021-01-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-01-06
- 2021-01-07
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-27
- 2021-02-02
-
2021-02-05
Dose 2 — Moderna
-
2021-02-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · HeadacheAdult check-in
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-27
- 2021-03-07
- 2021-03-13
- 2021-03-19
-
2021-05-08
Survey response — 3 months, dose 2MedDRA: Cough, Headache, Influenza like illness, Influenza virus test negative, Malaise, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to workFree 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 dyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-08
Survey response — 6 months, dose 2MedDRA: 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 visitFree 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 baselineMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-08
Report sent to call center — 6 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 pr1 call case(s)
- 2021-08-11
- 2022-02-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-05 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-06 | priority 2/3 | |
| 2021-08-08 | Unsuccessful |
Free text
Release 8 — 3 months, dose 2
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Chills | ✓ | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Influenza like illness | ✓ | ✓ | ✓ |
| SD | Influenza virus test negative | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release