ZBX-63657-04470
3 vaccinations
6 coded responses
31 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 210 / MD
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Dose 1 — Moderna
-
2021-01-30
Registered in v-safe
-
2021-01-30
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Swelling · Headache, Fatigue or tirednessAdult check-in
- 2021-01-31
- 2021-02-01
- 2021-02-03
- 2021-02-10
- 2021-02-17
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Breast swelling — Feeling: Good · Site: SwellingFree text: Bra is little snug, in hind sight, it was last time. Maybe slight swelling. Doesn't ache or bother me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
-
2021-03-31
Survey response — day 35, dose 2MedDRA: Fatigue — Feeling: GoodFree text: Hind sight, extreme tiredness 3rd, 4th, 5th week after vaccine. Finally seems to be lessening.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
- 2021-05-26
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2021-08-25
Survey response — 6 months, dose 2MedDRA: Condition aggravated, Pre-existing disease, Ultrasound scan abnormal — Feeling: GoodFree text: Breast cysts increased in size after vaccinations according to diagnostic ultrasound. Scheduled for 6 month follow up with ultrasound.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-11-11
Dose 3 — Moderna
-
2021-11-16
Survey response — days 1–6 daily, dose 3MedDRA: Breast discomfort, Fatigue, Myalgia, Pyrexia — Feeling: Good · Site: Swelling · Muscle or body achesFree text: 24 hrs after booster had fever, breast discomfort,muscle aches and fatigue and tirednessMedDRA releases: 2024-11 · check-in free text available
-
2021-11-17
Survey response — days 1–6 daily, dose 3MedDRA: Adverse reaction, Breast pain, Myalgia — Feeling: Good · Muscle or body achesFree text: My booster was 11/11/21 most symptoms dissipated by 11/15 with exception of aching muscles and breast.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-16
- 2021-12-23
- 2022-02-10
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2022-05-12
Survey response — 6 months, dose 3MedDRA: Ear infection, Office visit, Upper respiratory tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Upper respiratory infection and an ear infection · Healthcare visit (other): Urgent care as no ENT available on Friday after noon, ENT & PC doctorMedDRA releases: 2024-11 · check-in free text available
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2022-05-12
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-13
-
2022-05-13
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 | 2021-01-27 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-12 | Successful 2022-05-13 |
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 2
Systemic reaction (other): Bra is little snug, in hind sight, it was last time. Maybe slight swelling. Doesn't ache or bother me.
Release 6 — day 35, dose 2
Symptoms: Hind sight, extreme tiredness 3rd, 4th, 5th week after vaccine. Finally seems to be lessening.
Release 9 — 6 months, dose 2
Symptoms: Breast cysts increased in size after vaccinations according to diagnostic ultrasound. Scheduled for 6 month follow up with ultrasound.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): 24 hrs after booster had fever, breast discomfort,muscle aches and fatigue and tiredness
Systemic reaction (other): My booster was 11/11/21 most symptoms dissipated by 11/15 with exception of aching muscles and breast.
Release 11 — 6 months, dose 3
Symptoms: Upper respiratory infection and an ear infection
Healthcare visit (other): Urgent care as no ENT available on Friday after noon, ENT & PC doctor
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 | Condition aggravated | ✓ | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | Ultrasound scan abnormal | ✓ | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Breast discomfort | · | · | ✓ |
| SRO | Breast pain | · | · | ✓ |
| SRO | Breast swelling | ✓ | ✓ | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release