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Z9S-12212-25629

4 vaccinations 5 coded responses 31 check-ins 4 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
804 / CO
Registered
2021-02-15
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-15
    Registered in v-safe
  2. 2021-02-15
    Dose 1 — Moderna
  3. 2021-02-15
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-02-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-02-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  6. 2021-02-18
    Survey response — days 1–6 daily, dose 1
    MedDRA: Unevaluable event — Feeling: Good
    Free text: I suspect I may have a UTI as of this morning but hard to believe it's related
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-22
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-03-01
    Survey response — day 14, dose 1
    MedDRA: Abdominal discomfort, Arthralgia, Fatigue, Headache, Myalgia, Neck pain — Feeling: Fair
    Free text: Saturday 2/27 I was extremely fatigued, had headache, and upset stomach. Also muscle pains in neck/shoulders that I initially thought was due to a new exercise regime except that it has lasted a week.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-08
    Survey response — day 21, dose 1
    MedDRA: Dizziness, Fatigue, Nausea — Feeling: Good · Be unable to do your normal daily activities
    Free text: No idea if it's related, but 4 days ago I awoke with my head spinning, somewhat nauseated and very tired. It gradually cleared over the next 30 or so hours.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-19
    Dose 2 — Moderna
  14. 2021-03-19
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-03-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-03-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Joint pains, Muscle or body aches
    Adult check-in
  17. 2021-03-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-03-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache, Abdominal pain
    Adult check-in
  19. 2021-03-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache, Abdominal pain
    Adult check-in
  20. 2021-03-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Muscle or body aches
    Adult check-in
  21. 2021-03-26
    Health check-in — day 7, dose 2
    Feeling: Fair · Nausea
    Adult check-in
  22. 2021-04-16
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-26
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-30
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  25. 2021-06-18
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-11-05
    Dose 3 — Moderna
  27. 2022-03-19
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2022-04-14
    Dose 4 — Moderna
  29. 2022-04-28
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  30. 2022-05-06
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  31. 2022-05-14
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  32. 2022-05-21
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  33. 2022-05-26
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  34. 2022-07-18
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  35. 2022-10-13
    Survey response — 6 months, dose 4
    MedDRA: COVID-19 — Feeling: Good · 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: COVID.
    MedDRA releases: 2024-11 · check-in free text available
  36. 2022-10-13
    Report sent to call center — 6 months, dose 4
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  37. 2022-10-14
  38. 2022-10-19
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  39. 2023-04-14
    Survey response — 12 months, dose 4
    MedDRA: Adverse reaction, Epistaxis, Headache, Sinus congestion — Feeling: Fair
    MedDRA releases: 2024-11

Vaccinations

DoseDateManufacturerCo-administered
12021-02-15Moderna
22021-03-19Moderna
32021-11-05Moderna No
42022-04-14Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2022-10-13 Successful
2022-10-19
 Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-18

Systemic reaction (other): I suspect I may have a UTI as of this morning but hard to believe it's related

Release 4 — day 14, dose 1

2021-03-01

Symptoms: Saturday 2/27 I was extremely fatigued, had headache, and upset stomach. Also muscle pains in neck/shoulders that I initially thought was due to a new exercise regime except that it has lasted a week.

Release 5 — day 21, dose 1

2021-03-08

Symptoms: No idea if it's related, but 4 days ago I awoke with my head spinning, somewhat nauseated and very tired. It gradually cleared over the next 30 or so hours.

Release 12 — 6 months, dose 4

2022-10-13

Symptoms: COVID.

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
SDAbdominal discomfort ✓ ✓ ✓
SDAdverse reaction · · ✓
SDArthralgia ✓ ✓ ✓
SDCOVID-19 · · ✓
SDDizziness ✓ ✓ ✓
SDEpistaxis · · ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDMyalgia ✓ ✓ ✓
SDNausea ✓ ✓ ✓
SDNeck pain ✓ ✓ ✓
SDSinus congestion · · ✓
SROUnevaluable event ✓ ✓ ✓

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

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