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ZEE-18033-51286

3 vaccinations 6 coded responses 26 check-ins 6 free-text entries 2 call cases
Sex
Male
Age at first dose
61-65
ZIP prefix
934 / CA
Registered
2021-03-22
Relationship
Self
Race
American Indian or Alaska Native
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-03-22
    Registered in v-safe
  2. 2021-03-22
    Dose 1 — Moderna
  3. 2021-03-22
    Health check-in — day 0, dose 1
    Feeling: Good · Chills, Headache
    Adult check-in
  4. 2021-03-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-03-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache
    Adult check-in
  7. 2021-03-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Joint pains, Muscle or body aches
    Adult check-in
  8. 2021-03-27
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Joint pains, Muscle or body aches
    Adult check-in
  9. 2021-03-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Muscle or body aches
    Adult check-in
  10. 2021-03-29
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-04-05
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-04-12
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-04-16
    Dose 2 — Moderna
  14. 2021-04-16
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  15. 2021-04-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-04-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-04-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-04-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Chills
    Adult check-in
  19. 2021-04-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Chills
    Adult check-in
  20. 2021-04-23
    Health check-in — day 7, dose 2
    Feeling: Good · Chills
    Adult check-in
  21. 2021-04-30
    Survey response — day 14, dose 2
    MedDRA: Blood glucose increased, Fatigue, Headache, Hypersomnia, Muscle spasms, Pollakiuria — Feeling: Fair
    Free text: Elevated glucose levels; metabolism increased; headaches and cramping in my fingers; frequent urination overnight; fatigue even after sleeping 10-12 hours
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-05-07
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  23. 2021-05-14
    Survey response — day 28, dose 2
    MedDRA: Back pain, Headache, Hypertension, Muscle spasms, Pollakiuria, Weight decreased — Feeling: Fair
    Free text: High glucose levels, cramps,backache,headaches,weight loss,frequent urination.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-05-21
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  25. 2021-05-29
    Survey response — day 42, dose 2
    MedDRA: Kidney infection — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Kidney infection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-07-16
    Survey response — 3 months, dose 2
    MedDRA: Immunisation reaction, Kidney infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Kidney infection from an adverse reaction to the vaccine.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  27. 2021-07-16
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  28. 2021-07-24
  29. 2021-10-17
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  30. 2022-01-19
    Dose 3 — Moderna
  31. 2022-04-18
    Survey response — 12 months, dose 2
    MedDRA: Weight decreased — Feeling: Poor
    Free text: Significant weight loss of 30 plus pounds
    MedDRA releases: 2024-11 · check-in free text available
  32. 2022-07-20
    Survey response — 6 months, dose 3
    MedDRA: Bacterial infection, Fungal infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit
    Free text: Bacterial infection in July 2022 and a Fungal infection in June 2022
    MedDRA releases: 2024-11 · check-in free text available
  33. 2022-07-20
    Report sent to call center — 6 months, dose 3
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
  34. 2022-07-21
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-03-22Moderna
22021-04-16Moderna
32022-01-19Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-07-16 Successful Participant prefers to complete VAERS report online
2022-07-20 Successful
2022-07-21
Participant prefers to complete VAERS report online

Free text

Release 8 — day 14, dose 2

2021-04-30

Symptoms: Elevated glucose levels; metabolism increased; headaches and cramping in my fingers; frequent urination overnight; fatigue even after sleeping 10-12 hours

Release 8 — day 28, dose 2

2021-05-14

Symptoms: High glucose levels, cramps,backache,headaches,weight loss,frequent urination.

Release 8 — day 42, dose 2

2021-05-29

Symptoms: Kidney infection

Release 9 — 3 months, dose 2

2021-07-16

Symptoms: Kidney infection from an adverse reaction to the vaccine.

Release 11 — 12 months, dose 2

2022-04-18

Symptoms: Significant weight loss of 30 plus pounds

Release 12 — 6 months, dose 3

2022-07-20

Symptoms: Bacterial infection in July 2022 and a Fungal infection in June 2022

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
SDBack pain ✓ ✓ ✓
SDBacterial infection · · ✓
SDBlood glucose increased ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDFungal infection · · ✓
SDHeadache ✓ ✓ ✓
SDHypersomnia ✓ ✓ ✓
SDHypertension ✓ ✓ ✓
SDImmunisation reaction ✓ · ✓
SDKidney infection ✓ ✓ ✓
SDMuscle spasms ✓ ✓ ✓
SDPollakiuria ✓ ✓ ✓
SDWeight decreased ✓ ✓ ✓

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