ZCJ-21059-65934
4 vaccinations
4 coded responses
54 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 193 / PA
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Registered in v-safe
-
2021-01-26
Dose 1 — Moderna
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-09
- 2021-02-16
-
2021-02-23
Dose 2 — Moderna
- 2021-02-23
-
2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Dizziness, Hyperhidrosis — Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: The chills occurred during the night and then went to sweating and lightheadedness. No chills or sweats today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-05-25
- 2021-08-24
-
2021-11-22
Dose 3 — Moderna
- 2021-11-22
-
2021-11-23
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-24
- 2021-11-25
- 2021-11-26
- 2021-11-27
- 2021-11-28
- 2021-11-29
-
2021-12-06
Survey response — day 14, dose 3MedDRA: Cough, Fatigue, Pyrexia, Quarantine, Sneezing — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: From 11/28-12/3 I had a low temperature (100.4 for 2 days), coughing, sneezing, fatigue. My husband had the same conditions beginning 2 days earlier. 12/5 was the first day without coughing and sneezing but still nose blowing. I am still fatigued. · Healthcare visit (other): The Dr had my husband get a Rapid Covid test. It was negative. The Dr thought it could be a false negative or a flu-like infection or a reaction to the Moderna booster we got on 11/22. He prescribed for us vitamins, Advil, Tussin DM, quaratine.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-06
Report sent to call center — day 14, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-08
-
2021-12-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-13
- 2021-12-20
- 2021-12-27
- 2022-01-03
- 2022-02-21
- 2022-05-23
-
2023-01-17
Dose 4 — Moderna
- 2023-01-17
-
2023-01-18
Survey response — days 1–6 daily, dose 4MedDRA: Night sweats — Feeling: Fair · Headache, Joint pains, Fatigue or tirednessMedDRA releases: 2024-11
- 2023-01-19
- 2023-01-20
- 2023-01-21
- 2023-01-22
- 2023-01-23
- 2023-01-24
- 2023-01-31
-
2023-02-07
Survey response — day 21, dose 4MedDRA: Epistaxis, Sneezing — Feeling: GoodMedDRA releases: 2024-11
- 2023-02-14
- 2023-02-21
- 2023-02-28
- 2023-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-23 | Moderna | |
| 3 | 2021-11-22 | Moderna | No |
| 4 | 2023-01-17 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-06 | Successful 2021-12-08 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): The chills occurred during the night and then went to sweating and lightheadedness. No chills or sweats today.
Release 10 — day 14, dose 3
Symptoms: From 11/28-12/3 I had a low temperature (100.4 for 2 days), coughing, sneezing, fatigue. My husband had the same conditions beginning 2 days earlier. 12/5 was the first day without coughing and sneezing but still nose blowing. I am still fatigued.
Healthcare visit (other): The Dr had my husband get a Rapid Covid test. It was negative. The Dr thought it could be a false negative or a flu-like infection or a reaction to the Moderna booster we got on 11/22. He prescribed for us vitamins, Advil, Tussin DM, quaratine.
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 | Quarantine | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Epistaxis | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Night sweats | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release