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ZDU-80424-54562

4 vaccinations 4 coded responses 27 check-ins 3 free-text entries 3 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
921 / CA
Registered
2021-01-14
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-14
    Registered in v-safe
  2. 2021-01-14
    Dose 1 — Moderna
  3. 2021-01-14
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-01-15
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to do your normal daily activities
    1 call case(s)
  6. 2021-01-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Redness, Swelling · None
    Adult check-in
  7. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Redness, Swelling · None
    Adult check-in
  8. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  9. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-22
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling · None
    Adult check-in
  11. 2021-01-28
    Survey response — day 14, dose 1
    MedDRA: Autoimmune disorder, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: The vaccine seemed to cause a relapse in my no name autoimmune disease for which i take enbrel. It resolved within two weeks.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-01-28
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-02-06
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-02-11
    Dose 2 — Moderna
  15. 2021-02-11
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  16. 2021-02-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  17. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  18. 2021-02-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Autoimmune disorder — Feeling: Poor · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities
    Free text: I think that this is activation of my underlying autoimmune disease for which i take enbrel. This occurred after the 1st dose of moderna as well
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-02-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  20. 2021-02-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  21. 2021-02-20
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-03-04
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-11
    Survey response — day 28, dose 2
    MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: I have an unnamed autoimmune illness for which i take enbrel. I dont know if it is connected but since the vaccine i have had more symptoms and have taken more medication
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-03-18
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-25
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-04-23
  27. 2021-04-24
  28. 2021-05-13
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-08-12
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  30. 2021-08-16
    Dose 3 — Moderna
  31. 2021-11-15
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  32. 2022-02-14
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  33. 2022-08-18
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in
  34. 2022-09-17
    Dose 4 — Pfizer-BioNTech
  35. 2022-10-14
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  36. 2023-03-18
    Survey response — 6 months, dose 4
    MedDRA: Respiratory syncytial virus infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  37. 2023-03-18
    Report sent to call center — 6 months, dose 4
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  38. 2023-03-20
  39. 2023-03-20

Vaccinations

DoseDateManufacturerCo-administered
12021-01-14Moderna
22021-02-11Moderna
32021-08-16Moderna No
42022-09-17Pfizer-BioNTech No

Call center

ReportedOutcomeVAERS-related outcome
2021-01-15 priority 2/3
2021-01-28 Unsuccessful
2023-03-18 Unsuccessful

Free text

Release 3 — day 14, dose 1

2021-01-28

Symptoms: The vaccine seemed to cause a relapse in my no name autoimmune disease for which i take enbrel. It resolved within two weeks.

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): I think that this is activation of my underlying autoimmune disease for which i take enbrel. This occurred after the 1st dose of moderna as well

Release 5 — day 28, dose 2

2021-03-11

Symptoms: I have an unnamed autoimmune illness for which i take enbrel. I dont know if it is connected but since the vaccine i have had more symptoms and have taken more medication

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

FieldPreferred term2021-092023-042024-11
SDAutoimmune disorder ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDRespiratory syncytial virus infection · · ✓
SROAutoimmune disorder ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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