Z9Q-12064-03216
1 vaccination
3 coded responses
14 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 278 / NC
- Registered
- 2021-03-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-01
Registered in v-safe
-
2021-03-01
Dose 1 — Moderna
- 2021-03-01
- 2021-03-02
- 2021-03-03
-
2021-03-04
Survey response — days 1–6 daily, dose 1MedDRA: Chest discomfort, Cough — Feeling: Fair · Headache, Muscle or body achesFree text: A tightness in the upper chest/throat thats like the feeling of a cold coming on - coughing some, nonproductive.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
-
2021-03-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, NauseaAdult check-in
- 2021-03-07
- 2021-03-08
- 2021-03-15
-
2021-03-22
Survey response — day 21, dose 1MedDRA: Irritable bowel syndrome, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I am experiencing a prolonged attack of IBS, with which I was diagnosed in 2012. It has been at least several years since I have had an attack like this, though I always have mild sx that are manageable. Have called my GI doctor for assistance.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-29
Survey response — day 28, dose 1MedDRA: Abdominal distension, Abdominal pain, Diarrhoea, Irritable bowel syndrome — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Continuing flare of IBS. Diarrhea, significant abdominal cramping, bloating. Been going on for 10 days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-29
Report sent to call center — day 28, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-31
- 2021-09-02
- 2022-03-02
- 2022-03-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-01 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-29 | Unsuccessful |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): A tightness in the upper chest/throat thats like the feeling of a cold coming on - coughing some, nonproductive.
Release 6 — day 21, dose 1
Symptoms: I am experiencing a prolonged attack of IBS, with which I was diagnosed in 2012. It has been at least several years since I have had an attack like this, though I always have mild sx that are manageable. Have called my GI doctor for assistance.
Release 6 — day 28, dose 1
Symptoms: Continuing flare of IBS. Diarrhea, significant abdominal cramping, bloating. Been going on for 10 days.
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 | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Abdominal pain | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Irritable bowel syndrome | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release