Z9Z-31818-98973
5 vaccinations
4 coded responses
58 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 945 / CA
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-30
Registered in v-safe
-
2021-01-30
Dose 1 — Moderna
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-13
- 2021-02-20
- 2021-02-27
- 2021-03-06
-
2021-03-09
Dose 2 — Moderna
- 2021-03-09
-
2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
-
2021-03-23
Survey response — day 14, dose 2MedDRA: Abdominal pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Abdominal pain for 5 days. Low grade fever.Not sure if this is related to the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-06-10
-
2021-09-07
Survey response — 6 months, dose 2MedDRA: Diverticulitis, Hospitalisation — Feeling: GoodFree text: I was hospitalized for small intestine diverticulitisMedDRA releases: 2024-11 · check-in free text available
-
2021-10-20
Dose 3 — Moderna
- 2021-10-25
- 2021-10-26
- 2021-10-27
- 2021-11-03
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2022-01-19
-
2022-04-14
Dose 4 — Moderna
- 2022-04-14
-
2022-04-15
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-19
-
2022-05-26
Survey response — day 42, dose 4MedDRA: Pain, Pyrexia, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Had a fever for two days, congestion, body aches. I was going to take a covid test just to rule out covid. I could just have a cold.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-14
Survey response — 3 months, dose 4MedDRA: COVID-19, Hypoacusis, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I had Covid in May 2022. I was fully vaccinated and had all my boosters. Since then I have had difficulty with my hearing. Don't know if it is covid related. I have a doctors appointment this month. Just thought I would mention it. · Healthcare visit (other): Upcoming drs appointment this monthMedDRA releases: 2024-11 · check-in free text available
-
2022-07-14
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-07-15
-
2022-07-15
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-09-28
Dose 5 — Moderna
- 2022-10-06
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-11-09
- 2022-12-28
- 2023-03-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna | |
| 2 | 2021-03-09 | Moderna | |
| 3 | 2021-10-20 | Moderna | No |
| 4 | 2022-04-14 | Moderna | No |
| 5 | 2022-09-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-14 | Successful 2022-07-15 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 6 — day 14, dose 2
Symptoms: Abdominal pain for 5 days. Low grade fever.Not sure if this is related to the vaccine.
Release 9 — 6 months, dose 2
Symptoms: I was hospitalized for small intestine diverticulitis
Release 11 — day 42, dose 4
Symptoms: Had a fever for two days, congestion, body aches. I was going to take a covid test just to rule out covid. I could just have a cold.
Release 12 — 3 months, dose 4
Symptoms: I had Covid in May 2022. I was fully vaccinated and had all my boosters. Since then I have had difficulty with my hearing. Don't know if it is covid related. I have a doctors appointment this month. Just thought I would mention it.
Healthcare visit (other): Upcoming drs appointment this 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 | Unevaluable event | · | · | ✓ |
| SD | Abdominal pain | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diverticulitis | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Hypoacusis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release