Z9C-18347-08348
4 vaccinations
5 coded responses
26 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 201 / VA
- Registered
- 2021-04-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
7AM-10680-03047
Child or adolescent in my care · Male · 2022-05-23
Timeline
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2021-04-01
Dose 1 — Moderna
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2021-04-03
Registered in v-safe
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2021-04-03
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Pyrexia — Feeling: FairFree text: April 1st, day 1 I had a fever and chillsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-04-05
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2021-04-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-04-08
Health check-in — day 7, dose 1Feeling: Fair · Joint pains, Muscle or body aches, DiarrheaAdult check-in
- 2021-04-15
- 2021-04-22
- 2021-04-29
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2021-05-03
Dose 2 — Moderna
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2021-05-03
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-05-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-05-05
- 2021-05-06
- 2021-05-07
- 2021-05-08
- 2021-05-10
- 2021-05-19
- 2021-05-27
- 2021-05-31
- 2021-06-09
- 2021-06-14
- 2021-08-02
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2021-11-03
Survey response — 6 months, dose 2MedDRA: Feeding disorder, Headache, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Headaches have been bad this year, in sept headache was so bad I throw up and couldn't eat for 2 days, headache was 48hrs and then every morning woke up with a headache for a week.MedDRA releases: 2024-11 · check-in free text available
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2021-12-16
Dose 3 — Moderna
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2022-05-03
Survey response — 12 months, dose 2MedDRA: Hypersensitivity, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Seasonal Allergies are really bad these past 2 weeks!MedDRA releases: 2024-11 · check-in free text available
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2022-06-16
Survey response — 6 months, dose 3MedDRA: Asthma, Medical counselling, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Asthma getting worse · Healthcare visit (other): Called my allergist who gave me steroids for 5 days to calm asthmaMedDRA releases: 2024-11 · check-in free text available
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2022-06-16
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-06-17
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2022-11-16
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-12-18
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2022-12-18
Survey response — 12 months, dose 3MedDRA: Aphonia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I lose my voice for a week once a month.MedDRA releases: 2024-11 · check-in free text available
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2022-12-18
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-12-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-05-03 | Moderna | |
| 3 | 2021-12-16 | Moderna | No |
| 4 | 2022-11-16 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-16 | Successful | Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-12-18 | Successful 2022-12-19 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): April 1st, day 1 I had a fever and chills
Release 10 — 6 months, dose 2
Symptoms: Headaches have been bad this year, in sept headache was so bad I throw up and couldn't eat for 2 days, headache was 48hrs and then every morning woke up with a headache for a week.
Release 11 — 12 months, dose 2
Symptoms: Seasonal Allergies are really bad these past 2 weeks!
Release 12 — 6 months, dose 3
Symptoms: Asthma getting worse
Healthcare visit (other): Called my allergist who gave me steroids for 5 days to calm asthma
Release 12 — 12 months, dose 3
Symptoms: I lose my voice for a week once a month.
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 | Medical counselling | · | · | ✓ |
| SD | Aphonia | · | · | ✓ |
| SD | Asthma | · | · | ✓ |
| SD | Feeding disorder | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release