ZDA-26900-65376
3 vaccinations
3 coded responses
28 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 960 / CA
- Registered
- 2021-02-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-08
Registered in v-safe
-
2021-02-08
Dose 1 — Moderna
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
-
2021-02-22
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pruritus, Injection site rash, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: I have a large rash on my left arm which circles my arm between the point of my shot and for several inches below that. It is very pink and itches. · Healthcare visit (other): I had appointment with my regular medical facility. They want me back for another appointment in two days. They have ordered a salve for me to use for the next week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-22
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-01
Survey response — day 21, dose 1MedDRA: Office visit, Skin swelling — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Arm which received shot puffed up to more than half my normal arm size from shot area to a few inches below my elbow. Very uncomfortable. I went to my doctor twice. He advised that l DID NOT get the second shot. · Healthcare visit (other): Regular doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-01
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-08
Dose 2 — Moderna
- 2021-03-08
-
2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Fever · Joint pains, Muscle or body achesAdult check-in
-
2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Swelling · Muscle or body achesAdult check-in
- 2021-03-11
-
2021-03-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling · Fatigue or tirednessAdult check-in
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-22
- 2021-07-30
- 2021-09-08
-
2021-10-23
Dose 3 — Moderna
- 2021-10-25
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Poor quality sleep — Feeling: Good · Fatigue or tirednessFree text: Did not sleep well last nightMedDRA releases: 2024-11 · check-in free text available
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-07
- 2021-11-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-08 | Moderna | |
| 2 | 2021-03-08 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-22 | Unsuccessful | |
| 2021-03-01 | Unsuccessful |
Free text
Release 4 — day 14, dose 1
Symptoms: I have a large rash on my left arm which circles my arm between the point of my shot and for several inches below that. It is very pink and itches.
Healthcare visit (other): I had appointment with my regular medical facility. They want me back for another appointment in two days. They have ordered a salve for me to use for the next week.
Release 4 — day 21, dose 1
Symptoms: Arm which received shot puffed up to more than half my normal arm size from shot area to a few inches below my elbow. Very uncomfortable. I went to my doctor twice. He advised that l DID NOT get the second shot.
Healthcare visit (other): Regular doctor
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Did not sleep well last night
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 | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Skin swelling | ✓ | ✓ | ✓ |
| SRO | Poor quality sleep | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release