ZD3-17323-39393
4 vaccinations
3 coded responses
47 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 750 / TX
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
-
2021-02-04
Survey response — day 14, dose 1MedDRA: Immunisation reaction, Injection site erythema, Injection site warmth — Feeling: GoodFree text: COVID Arm - the area around the injection site is red and warm, approximately 2 x 4 inches that I noticed 3 days ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-18
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
-
2021-03-10
Survey response — day 14, dose 2MedDRA: Discomfort, Injection site pain, Swelling — Feeling: GoodFree text: Soreness at the 1st dose (Jan 21) injection site left arm recurred this week after no soreness since the week after injection. There is some swelling, mild discomfort, but no fever in it. No soreness at last injection (Feb 24) site right arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
-
2021-05-26
Survey response — 3 months, dose 2MedDRA: Abdominal pain lower, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Fever 101.0 lower abdominal pain. Had rapid COVID test - negative. Urinalysis clear.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-26
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-25
-
2021-10-25
Dose 3 — Moderna
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
- 2022-04-25
-
2022-05-12
Call successfulDoes not wish to fill out VAERS report
-
2022-06-01
Dose 4 — Moderna
- 2022-06-04
- 2022-06-05
- 2022-06-06
- 2022-06-07
- 2022-06-08
- 2022-06-15
- 2022-06-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-06-01 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-26 | Successful 2022-05-12 |
Does not wish to fill out VAERS report |
Free text
Release 3 — day 14, dose 1
Symptoms: COVID Arm - the area around the injection site is red and warm, approximately 2 x 4 inches that I noticed 3 days ago.
Release 5 — day 14, dose 2
Symptoms: Soreness at the 1st dose (Jan 21) injection site left arm recurred this week after no soreness since the week after injection. There is some swelling, mild discomfort, but no fever in it. No soreness at last injection (Feb 24) site right arm.
Release 8 — 3 months, dose 2
Symptoms: Fever 101.0 lower abdominal pain. Had rapid COVID test - negative. Urinalysis clear.
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 | Abdominal pain lower | ✓ | ✓ | ✓ |
| SD | Discomfort | ✓ | ✓ | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release