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Z9G-18244-07421

2 vaccinations 5 coded responses 24 check-ins 5 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
373 / TN
Registered
2021-01-17
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-16
    Dose 1 — Moderna
  2. 2021-01-17
    Registered in v-safe
  3. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  8. 2021-01-23
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-01
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-06
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-13
    Dose 2 — Moderna
  12. 2021-02-13
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  13. 2021-02-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Erythema, Feeling hot, Pre-existing disease — Feeling: Good · Site: Pain · Fever · Headache · Be unable to do your normal daily activities
    Free text: My right cheek and ear turned red and hot, the same way it does when I take a Medrol (prednisolone). I have Sjogrens.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-02-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site rash, Injection site swelling, Injection site urticaria — Feeling: Good · Rash, not including the immediate area around the injection site
    Free text: I have a rash/welt about 1 1/2 inch, roundish, with raised edge, on the arm I got the shot - but its about four inches from the site. So Im not sure it has anything to do with the vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-02-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oropharyngeal pain — Feeling: Good
    Free text: Slight sore throat last night and this morning, gone now.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-02-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-02-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-20
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-02-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-06
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-13
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-20
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-27
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-15
    Survey response — 3 months, dose 2
    MedDRA: Basal cell carcinoma — Feeling: Good
    Free text: Basal cell cancer on forehead, removed in total using MOHS.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-08-14
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2022-02-13
    Survey response — 12 months, dose 2
    MedDRA: Colitis microscopic, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Microscopic colitis · Healthcare visit (other): In-person appt with Gastro and lower scope ordered
    MedDRA releases: 2024-11 · check-in free text available
  28. 2022-02-13
    Report sent to call center — 12 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  29. 2022-02-21

Vaccinations

DoseDateManufacturerCo-administered
12021-01-16Moderna
22021-02-13Moderna

Call center

ReportedOutcomeVAERS-related outcome
2022-02-13 Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): My right cheek and ear turned red and hot, the same way it does when I take a Medrol (prednisolone). I have Sjogrens.

2021-02-15

Systemic reaction (other): I have a rash/welt about 1 1/2 inch, roundish, with raised edge, on the arm I got the shot - but its about four inches from the site. So Im not sure it has anything to do with the vaccine.

2021-02-17

Systemic reaction (other): Slight sore throat last night and this morning, gone now.

Release 8 — 3 months, dose 2

2021-05-15

Symptoms: Basal cell cancer on forehead, removed in total using MOHS.

Release 11 — 12 months, dose 2

2022-02-13

Symptoms: Microscopic colitis
Healthcare visit (other): In-person appt with Gastro and lower scope ordered

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 · · ✓
SDBasal cell carcinoma ✓ ✓ ✓
SDColitis microscopic · · ✓
SROErythema ✓ ✓ ✓
SROFeeling hot ✓ ✓ ✓
SROInjection site rash ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROInjection site urticaria ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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