ZB9-25602-41413
4 vaccinations
2 coded responses
51 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 967 / HI
- Registered
- 2021-04-16
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-04-15
Dose 1 — Moderna
-
2021-04-16
Registered in v-safe
-
2021-04-16
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Good · Site: PainFree text: Light-headed after intial shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-29
- 2021-05-06
-
2021-05-13
Dose 2 — Moderna
- 2021-05-13
- 2021-05-14
- 2021-05-15
- 2021-05-16
- 2021-05-17
- 2021-05-18
- 2021-05-19
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-06-10
- 2021-06-17
- 2021-06-24
- 2021-08-12
-
2021-08-15
Dose 3 — Moderna
- 2021-08-15
-
2021-08-16
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling · Fever · NoneAdult check-in
- 2021-08-17
- 2021-08-18
- 2021-08-19
- 2021-08-20
- 2021-08-21
- 2021-08-22
- 2021-08-29
- 2021-09-05
- 2021-09-12
- 2021-09-19
- 2021-09-26
- 2021-11-16
- 2022-02-13
- 2022-08-15
-
2022-10-25
Dose 4 — Moderna
- 2022-10-26
- 2022-10-27
-
2022-10-28
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Nausea, DiarrheaAdult check-in
- 2022-10-29
- 2022-10-31
- 2022-11-01
- 2022-11-08
- 2022-11-15
- 2022-11-22
- 2022-11-29
- 2023-01-24
-
2023-04-25
Survey response — 6 months, dose 4MedDRA: Brain fog, COVID-19, Chills, Fatigue, Pain, Pyrexia, Respiratory tract congestion — 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 · Emergency room or emergency department visitMedDRA releases: 2024-11
-
2023-04-25
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
- 2023-04-26
- 2023-04-27
- 2023-04-28
-
2023-05-02
Callback requested for04:30PM ET
- 2023-05-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-15 | Moderna | |
| 2 | 2021-05-13 | Moderna | |
| 3 | 2021-08-15 | Moderna | No |
| 4 | 2022-10-25 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-04-25 | Unsuccessful |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Light-headed after intial shot
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 | Brain fog | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release