ZAL-20158-80665
4 vaccinations
8 coded responses
42 check-ins
8 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 107 / NY
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Moderna
- 2021-02-13
-
2021-02-14
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: The mild pain is in the injection site. It was expected.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
- 2021-02-17
-
2021-02-18
Survey response — days 1–6 daily, dose 1MedDRA: Prostate cancer — Feeling: GoodFree text: Maybe you should know that I was very recently diagnosed with prostate cancer.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-19
Survey response — days 1–6 daily, dose 1MedDRA: Prostate cancer — Feeling: GoodFree text: Just the recentliy diagnosed prostate cancer, whI mentioned yesterday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-02-27
- 2021-03-06
- 2021-03-13
-
2021-03-14
Dose 2 — Moderna
- 2021-03-20
-
2021-03-21
Survey response — day 7, dose 2MedDRA: Prostate cancer — Feeling: GoodFree text: I have recently diagnosed with prostate cancer and started hormone treatment 2 days ago with radiation to come-MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-28
- 2021-04-04
- 2021-04-11
- 2021-04-18
- 2021-04-25
-
2021-06-13
Survey response — 3 months, dose 2MedDRA: Arthritis, Asthenia, Fatigue, Office visit, Pre-existing disease, Respiratory tract congestion — Feeling: Fair · 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: Symptoms: Upper respiratory, non-covid, condition (congestion) - probably allergy-related. Also, fatigue, weakness, and increased severity of arthritis - most likely due to hormone deprivation trestments due to prostate cancer. · Healthcare visit (other): Visit to primary care physician and ct scan of lungs in addition to x-ray. Also prednisone and antibioticsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-13
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2021-09-12
-
2021-10-27
Dose 3 — Moderna
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-12
- 2021-11-17
- 2021-11-24
- 2021-12-01
-
2021-12-08
Survey response — day 42, dose 3MedDRA: SARS-CoV-2 test negative, Sinusitis — Feeling: GoodFree text: Sinus infection. Tested negative for Covid. Infection getting better.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-26
-
2022-04-12
Dose 4 — Moderna
- 2022-04-21
- 2022-04-26
- 2022-05-03
- 2022-05-10
-
2022-05-17
Survey response — day 35, dose 4MedDRA: Herpes simplex, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Herpes attack - right eye. I don't think it is covid or vaccine related · Healthcare visit (other): Scheduled bisit to eye doctorMedDRA releases: 2024-11 · check-in free text available
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2022-05-17
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-05-18
- 2022-05-18
-
2022-05-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-24
- 2022-07-12
-
2022-10-11
Survey response — 6 months, dose 4MedDRA: Prostatitis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: ProstatitusMedDRA releases: 2024-11 · check-in free text available
- 2023-04-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-14 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-13 | Successful 2021-06-22 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-05-17 | Successful 2022-05-20 |
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
Systemic reaction (other): The mild pain is in the injection site. It was expected.
Systemic reaction (other): Maybe you should know that I was very recently diagnosed with prostate cancer.
Systemic reaction (other): Just the recentliy diagnosed prostate cancer, whI mentioned yesterday.
Release 6 — day 7, dose 2
Systemic reaction (other): I have recently diagnosed with prostate cancer and started hormone treatment 2 days ago with radiation to come-
Release 9 — 3 months, dose 2
Symptoms: Upper respiratory, non-covid, condition (congestion) - probably allergy-related. Also, fatigue, weakness, and increased severity of arthritis - most likely due to hormone deprivation trestments due to prostate cancer.
Healthcare visit (other): Visit to primary care physician and ct scan of lungs in addition to x-ray. Also prednisone and antibiotics
Release 10 — day 42, dose 3
Symptoms: Sinus infection. Tested negative for Covid. Infection getting better.
Release 11 — day 35, dose 4
Symptoms: Herpes attack - right eye. I don't think it is covid or vaccine related
Healthcare visit (other): Scheduled bisit to eye doctor
Release 12 — 6 months, dose 4
Symptoms: Prostatitus
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Arthritis | ✓ | ✓ | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Herpes simplex | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Prostatitis | · | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Prostate cancer | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release