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ZBF-29489-67144

3 vaccinations 4 coded responses 17 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
207 / MD
Registered
2021-02-21
Relationship
Self
Race
American Indian or Alaska Native
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-19
    Dose 1 — Moderna
  2. 2021-02-21
    Registered in v-safe
  3. 2021-02-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  4. 2021-02-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  5. 2021-02-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  6. 2021-02-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-26
    Health check-in — day 7, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  8. 2021-03-05
    Survey response — day 14, dose 1
    MedDRA: Headache, Rhinorrhoea — Feeling: Good
    Free text: Felt like I had a cold with runny nose and a headache. Symptoms went away after a day or so.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-12
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-03-19
    Dose 2 — Moderna
  11. 2021-03-26
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-04-02
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-04-09
    Survey response — day 21, dose 2
    MedDRA: Chills, Fatigue, Gait disturbance, Headache, Loss of personal independence in daily activities, Pain — Feeling: Fair
    Free text: Body pains that have worsened each day, mild headaches, tired/exhaustion and some chills. Difficulty walking and doing regular activities but was able to do things slowly and with some medication.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-23
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-05-01
    Survey response — day 42, dose 2
    MedDRA: Arthralgia, Chills, Discomfort — Feeling: Good
    Free text: Felt chilly when everyone around was quite warm & left shoulder still feels different - annoying soreness,.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-06-18
    Survey response — 3 months, dose 2
    MedDRA: Asthenia, Blood cholesterol increased, Blood pressure increased, Glycosylated haemoglobin increased, Injection site pain, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Left arm (where shot was given) has pain and weakness. Elevated blood pressure and cholesterol levels as well as A1c (not sure if related). Discovered during recent health visit. · Healthcare visit (other): Regular visit
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-06-18
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  18. 2021-06-24
  19. 2021-06-30
  20. 2021-09-17
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-11-16
    Dose 3 — Moderna
  22. 2022-03-19
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  23. 2022-05-17
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  24. 2022-11-18
    Health check-in — 12 months, dose 3
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-19Moderna
22021-03-19Moderna
32021-11-16Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-06-18 Unsuccessful

Free text

Release 5 — day 14, dose 1

2021-03-05

Symptoms: Felt like I had a cold with runny nose and a headache. Symptoms went away after a day or so.

Release 7 — day 21, dose 2

2021-04-09

Symptoms: Body pains that have worsened each day, mild headaches, tired/exhaustion and some chills. Difficulty walking and doing regular activities but was able to do things slowly and with some medication.

Release 8 — day 42, dose 2

2021-05-01

Symptoms: Felt chilly when everyone around was quite warm & left shoulder still feels different - annoying soreness,.

Release 9 — 3 months, dose 2

2021-06-18

Symptoms: Left arm (where shot was given) has pain and weakness. Elevated blood pressure and cholesterol levels as well as A1c (not sure if related). Discovered during recent health visit.
Healthcare visit (other): Regular visit

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ ✓ ✓
SDArthralgia ✓ ✓ ✓
SDAsthenia ✓ ✓ ✓
SDBlood cholesterol increased ✓ ✓ ✓
SDBlood pressure increased ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDDiscomfort ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDGait disturbance ✓ ✓ ✓
SDGlycosylated haemoglobin increased ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDInjection site pain ✓ ✓ ✓
SDLoss of personal independence in daily activities ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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