ZCH-19054-39083
5 vaccinations
5 coded responses
25 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 775 / TX
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-13
Dose 1 — Moderna
-
2021-01-15
Registered in v-safe
-
2021-01-15
Survey response — days 1–6 daily, dose 1MedDRA: Gingival erythema, Gingival swelling, Loss of personal independence in daily activities, Pain, Pain in jaw, Rhinalgia, Toothache — Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My gums swelled and turn red, my front upper tooth is a crown with a post and I am experiencing excruciating throbbing pain that now spread to the teeth on my left side my my left nostril and my lower jaw. I cant chew I cant brush behind that front tooth it is so painful. I didnt have any issues with my teeth at all before the vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-15
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Gingival erythema, Gingival pruritus, Gingival swelling, Lip swelling, Pain, Self-medication, Swelling face — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My doctor prescribed antibiotics (AZITHROMYCIN 500mg), for my red swollen itchy gums, all the side effects r on left side of face. Im taking aleve for pain. And antihistamine for swelling in my upper lip, nostril, cheek, and jaw. I had none of these issues before vaccination...they all appear Ed one day laterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-16
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Lip swelling, Rash, Rhinalgia, Swelling face, Tenderness — Feeling: Fair · Rash, not including the immediate area around the injection siteFree text: I feel better today although I woke this morning with the left side of my face swollen quite a bit...my upper lip very swollen. Tenderness and pain at base of the left nostril. My injection was on left arm at very top. I forgot to add that on Thursday morning I did have a rash on my chest, that was morning after vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-19
- 2021-01-22
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Moderna
- 2021-04-14
- 2021-07-14
-
2021-10-13
Dose 3 — Moderna
-
2022-01-13
Survey response — 12 months, dose 1MedDRA: SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Good · Be unable to do your normal daily activitiesFree text: Severe upper respiratory infection since Christmas. Negative for COVID and on antibiotics Doing betterMedDRA releases: 2024-11 · check-in free text available
-
2022-05-16
Dose 4 — Pfizer-BioNTech
-
2022-09-26
Dose 5 — Pfizer-BioNTech
- 2022-09-26
- 2022-09-27
- 2022-09-28
- 2022-09-29
- 2022-09-30
- 2022-10-01
- 2022-10-02
- 2022-10-03
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-12-26
-
2023-03-27
Survey response — 6 months, dose 5MedDRA: Sinusitis — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | No |
| 3 | 2021-10-13 | Moderna | No |
| 4 | 2022-05-16 | Pfizer-BioNTech | No |
| 5 | 2022-09-26 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-15 | priority 2/3 | |
| 2021-01-16 | priority 2/3 |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): My gums swelled and turn red, my front upper tooth is a crown with a post and I am experiencing excruciating throbbing pain that now spread to the teeth on my left side my my left nostril and my lower jaw. I cant chew I cant brush behind that front tooth it is so painful. I didnt have any issues with my teeth at all before the vaccination.
Systemic reaction (other): My doctor prescribed antibiotics (AZITHROMYCIN 500mg), for my red swollen itchy gums, all the side effects r on left side of face. Im taking aleve for pain. And antihistamine for swelling in my upper lip, nostril, cheek, and jaw. I had none of these issues before vaccination...they all appear Ed one day later
Systemic reaction (other): I feel better today although I woke this morning with the left side of my face swollen quite a bit...my upper lip very swollen. Tenderness and pain at base of the left nostril. My injection was on left arm at very top. I forgot to add that on Thursday morning I did have a rash on my chest, that was morning after vaccination.
Release 10 — 12 months, dose 1
Symptoms: Severe upper respiratory infection since Christmas. Negative for COVID and on antibiotics Doing better
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 | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Gingival erythema | ✓ | ✓ | ✓ |
| SRO | Gingival pruritus | ✓ | ✓ | ✓ |
| SRO | Gingival swelling | ✓ | ✓ | ✓ |
| SRO | Lip swelling | ✓ | ✓ | ✓ |
| SRO | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rhinalgia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Swelling face | ✓ | ✓ | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
| SRO | Toothache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release