ZA5-26316-32033
3 vaccinations
5 coded responses
37 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 754 / TX
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Moderna
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
-
2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Night sweats — Feeling: GoodFree text: Night sweatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-18
- 2021-01-19
- 2021-01-26
- 2021-02-02
- 2021-02-09
-
2021-02-10
Dose 2 — Moderna
- 2021-02-10
-
2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Muscle or body achesAdult check-in
-
2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Night sweats — Feeling: GoodFree text: Night sweats last three nightsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
-
2021-10-22
Dose 3 — Moderna
-
2021-10-25
Survey response — days 1–6 daily, dose 3MedDRA: Chills, Decreased appetite, Fatigue, Headache, Nausea, Pain, Pyrexia — Feeling: GoodFree text: Got shot on Fri, 22 Oct. That evening and all the next day (Sat) I had chills, fever, body ache, headache and nausea. On Sunday I felt some better, but not 100%. Had no appetite. Today, 3rd day after shot (Mon, 25 Oct) I feel okay but mild fatigue.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-26
- 2021-10-28
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
-
2022-01-21
Survey response — 3 months, dose 3MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: GoodFree text: Runny nose, slight congestion. Minor issues.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-22
-
2022-10-24
Survey response — 12 months, dose 3MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: COVID booster Oct 2021. Bad cold in June 2022 but COVID test negative. Am fine now.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-24
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-10-25
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 | 2021-01-12 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-24 | Successful 2022-10-25 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Night sweat
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Night sweats last three nights
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Got shot on Fri, 22 Oct. That evening and all the next day (Sat) I had chills, fever, body ache, headache and nausea. On Sunday I felt some better, but not 100%. Had no appetite. Today, 3rd day after shot (Mon, 25 Oct) I feel okay but mild fatigue. cut off by CDC
Release 11 — 3 months, dose 3
Symptoms: Runny nose, slight congestion. Minor issues.
Release 12 — 12 months, dose 3
Symptoms: COVID booster Oct 2021. Bad cold in June 2022 but COVID test negative. Am fine now.
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 | Nasopharyngitis | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Decreased appetite | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Nausea | · | · | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release