ZCB-27322-03113
2 vaccinations
4 coded responses
18 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 982 / WA
- Registered
- 2021-02-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-06
Dose 1 — Moderna
-
2021-02-17
Registered in v-safe
- 2021-02-17
-
2021-02-20
Survey response — day 14, dose 1MedDRA: Dizziness, Unevaluable event, Vertigo — Feeling: PoorFree text: I have been having dizziness like vertigo symptoms for a couple of days but I dont think it is COVID-19 related. I will probably try to see a doctor if the symptoms persist.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-27
Survey response — day 21, dose 1MedDRA: Back pain, Chest pain, Dizziness, Herpes zoster, Medical counselling — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I started having pain in the right side of my chest and back about a week ago. I went to the doctor and I have shingles. This is my 2nd day on medication which goes for 7 days. I still have some dizziness. I had an MRI that showed no brain problems.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-27
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-06
Dose 2 — Moderna
- 2021-03-06
- 2021-03-07
-
2021-03-08
Survey response — days 1–6 daily, dose 2MedDRA: Herpes zoster — Feeling: Good · Site: PainFree text: I have shingles.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Survey response — days 1–6 daily, dose 2MedDRA: Herpes zoster, Pruritus — Feeling: FairFree text: My shingles itches.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-06-05
- 2021-09-04
- 2021-09-09
- 2022-03-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-06 | Moderna | |
| 2 | 2021-03-06 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-27 | Unsuccessful |
Free text
Release 4 — day 14, dose 1
Symptoms: I have been having dizziness like vertigo symptoms for a couple of days but I dont think it is COVID-19 related. I will probably try to see a doctor if the symptoms persist.
Release 4 — day 21, dose 1
Symptoms: I started having pain in the right side of my chest and back about a week ago. I went to the doctor and I have shingles. This is my 2nd day on medication which goes for 7 days. I still have some dizziness. I had an MRI that showed no brain problems. cut off by CDC
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): I have shingles.
Systemic reaction (other): My shingles itches.
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 | Back pain | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Herpes zoster | ✓ | ✓ | ✓ |
| SD | Medical counselling | ✓ | ✓ | ✓ |
| SD | Unevaluable event | ○ | ✓ | ○ |
| SD | Vertigo | ✓ | · | ✓ |
| SRO | Herpes zoster | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release