ZBC-12439-36292
1 vaccination
2 coded responses
5 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 921 / CA
- Registered
- 2021-04-14
- Relationship
- Self
- Race
- Asian
- Ethnicity
- N/A
Timeline
-
2021-04-01
Dose 1 — Moderna
-
2021-04-14
Registered in v-safe
-
2021-04-14
Survey response — day 7, dose 1MedDRA: Abdominal distension, Blepharospasm, Burning sensation, Disturbance in attention, Erythema, Feeling of body temperature change, Hypoaesthesia, Hypoaesthesia oral, Immunisation reaction, Injection site erythema, Injection site pain, Injection site swelling, Nausea, Office visit, Pain, Pruritus, Somnolence, Swelling — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness · 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: The night after my vaccination , itching on my feet and palms , patchy redness on palms , no fever but very drowsy..... exactly 5 days after the vaccination , injection site was swollen , red, and felt burning around it ..... felt numbness on left face , left side of my lips numb and felt swollen , neck , shoulder and back swollen with so much itchiness .... cant stay focus and been so drowsy feeling burning and hot while also feeling so cold on the other side ....nauseated and my eyes seemed twitching .... went to urgent care Saturday -April 10, and was informed Im having a reaction to the vaccine , was prescribed with Zyrtec and prednisone 5 mgs. In a dose pack and still taking it .... redness gone but still having itchiness and body aches , abdominal bloating ...MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-14
Report sent to call center — day 7, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-17
- 2021-04-22
-
2021-07-01
Survey response — 3 months, dose 1MedDRA: Pain in extremity, Paraesthesia — Feeling: FairFree text: On and off tingling pain on lower legsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2022-04-01
- 2022-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-14 | Unsuccessful |
Free text
Release 7 — day 7, dose 1
Systemic reaction (other): The night after my vaccination , itching on my feet and palms , patchy redness on palms , no fever but very drowsy..... exactly 5 days after the vaccination , injection site was swollen , red, and felt burning around it ..... felt numbness on left face , left side of my lips numb and felt swollen , neck , shoulder and back swollen with so much itchiness .... cant stay focus and been so drowsy feeling burning and hot while also feeling so cold on the other side ....nauseated and my eyes seemed twitching .... went to urgent care Saturday -April 10, and was informed Im having a reaction to the vaccine , was prescribed with Zyrtec and prednisone 5 mgs. In a dose pack and still taking it .... redness gone but still having itchiness and body aches , abdominal bloating ...
Release 9 — 3 months, dose 1
Symptoms: On and off tingling pain on lower legs
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 | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Abdominal distension | ✓ | ✓ | ✓ |
| SRO | Blepharospasm | ✓ | ✓ | ✓ |
| SRO | Burning sensation | ✓ | ✓ | ✓ |
| SRO | Disturbance in attention | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Feeling of body temperature change | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia oral | ✓ | ✓ | ✓ |
| SRO | Immunisation reaction | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Office visit | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release