ZEJ-27255-45834
2 vaccinations
3 coded responses
12 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 784 / TX
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-07
Registered in v-safe
-
2021-01-07
Dose 1 — Moderna
- 2021-01-07
- 2021-01-08
- 2021-01-12
- 2021-01-14
- 2021-01-21
- 2021-01-29
-
2021-02-04
Dose 2 — Moderna
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Swelling face, Vaccine positive rechallenge — Feeling: Fair · Site: Pain, Redness, Swelling, ItchingFree text: Chin swelled up it happened a few days after the 1shot and it did it again after my 2nd swelling lasted about 2hrs but its down nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-08
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tirednessFree text: Itching all over body on and offMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Fatigue or tirednessAdult check-in
- 2021-03-04
-
2021-03-11
Survey response — day 35, dose 2MedDRA: Dizziness, Dyspnoea, Fatigue, Malaise, Palpitations, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Dizziness fatigue palpitations light headed feeling faint at times episodes come and go and SOB sometimes I just feel off during the day just random episodes I have an appt with my PCP on 3/18 last palpitation episodes was tues on and off all day · Healthcare visit (other): Im Scheduled with my pcp on 3/18/21 for my symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-11
Report sent to call center — day 35, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-03-02
- 2022-03-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-11 | Unsuccessful |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Chin swelled up it happened a few days after the 1shot and it did it again after my 2nd swelling lasted about 2hrs but its down now
Systemic reaction (other): Itching all over body on and off
Release 5 — day 35, dose 2
Symptoms: Dizziness fatigue palpitations light headed feeling faint at times episodes come and go and SOB sometimes I just feel off during the day just random episodes I have an appt with my PCP on 3/18 last palpitation episodes was tues on and off all day
Healthcare visit (other): Im Scheduled with my pcp on 3/18/21 for my symptoms
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Swelling face | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release