ZDC-14810-65806
1 vaccination
2 coded responses
11 check-ins
2 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 773 / TX
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Moderna
- 2021-01-12
- 2021-01-13
-
2021-01-15
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
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
-
2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Lymphadenopathy, Pain in jaw, Self-medication — Feeling: Fair · Joint pains · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): My lymph nodes on my neck are swollen- its causing some pain and discomfort opening my mouth. It is very difficult to chew as the pain in the TMJ region radiating to my ear. · Healthcare visit (other): My wife is RNMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-17
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-01-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Joint pains, Muscle or body achesAdult check-in
- 2021-01-19
- 2021-01-26
- 2021-02-02
- 2021-02-09
- 2021-03-16
-
2021-07-13
Survey response — 6 months, dose 1MedDRA: Lung opacity, Total lung capacity decreased — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Unfortunately theres concern that I had an allergic reaction to the vaccine. I have undergone test that includes extensive lab, chest CT and PFT testing- my lungs has the ground glass appearance and lung capacity is very limited-MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-15 | Unsuccessful | |
| 2021-01-17 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): My lymph nodes on my neck are swollen- its causing some pain and discomfort opening my mouth. It is very difficult to chew as the pain in the TMJ region radiating to my ear.
Healthcare visit (other): My wife is RN
Release 9 — 6 months, dose 1
Symptoms: Unfortunately theres concern that I had an allergic reaction to the vaccine. I have undergone test that includes extensive lab, chest CT and PFT testing- my lungs has the ground glass appearance and lung capacity is very limited-
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 | Self-medication | ✓ | ✓ | ✓ |
| SD | Lung opacity | ✓ | ✓ | ✓ |
| SD | Total lung capacity decreased | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release