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ZER-23016-68911

3 vaccinations 13 coded responses 36 check-ins 13 free-text entries 1 call case
Sex
Male
Age at first dose
26-30
ZIP prefix
490 / MI
Registered
2021-03-25
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-25
    Registered in v-safe
  2. 2021-03-25
    Dose 1 — Moderna
  3. 2021-03-25
    Survey response — day 0, dose 1
    MedDRA: Hyperhidrosis, Immediate post-injection reaction — Feeling: Good · Site: Pain
    Free text: Increased sweating 10 mins after injection, lasting 45 mins total.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  5. 2021-03-27
    Survey response — days 1–6 daily, dose 1
    MedDRA: Abdominal pain, Chills — Feeling: Good · Site: Pain, Swelling · Chills, Abdominal pain
    Free text: Chills were experienced while in a 70°F room. No associated fever, only chills for an hour. Abdominal pain was diffuse, around Mcburney's point, and intermittently near the spleen.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Diarrhea, Abdominal pain
    Adult check-in
  7. 2021-03-29
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Diarrhea
    Adult check-in
  8. 2021-03-30
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site bruising, Injection site discolouration — Feeling: Good · Site: Itching
    Free text: Yellow colored, US quarter sized rash(similar to bruising or jaundice yellow) at injection site appeared today.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-31
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site discolouration, Injection site rash — Feeling: Good
    Free text: Yellow quarter sized "rash" at injection site still present
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-01
    Health check-in — day 7, dose 1
    Feeling: Good · Nausea
    Adult check-in
  11. 2021-04-08
    Survey response — day 14, dose 1
    MedDRA: Abdominal distension, Dyspepsia — Feeling: Good
    Free text: Have had indigestion and bloating issues
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-15
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-04-22
    Dose 2 — Moderna
  14. 2021-04-22
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  15. 2021-04-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Nausea
    Adult check-in
  16. 2021-04-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Abdominal pain
    Adult check-in
  17. 2021-04-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Swelling · Joint pains, Fatigue or tiredness
    Adult check-in
  18. 2021-04-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Joint pains, Fatigue or tiredness
    Adult check-in
  19. 2021-04-29
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-05-08
    Survey response — day 14, dose 2
    MedDRA: Pancreatitis — Feeling: Good · Be unable to do your normal daily activities
    Free text: I had acute pancreatitis, unrelated to the vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-05-16
    Survey response — day 21, dose 2
    MedDRA: Pancreatitis — Feeling: Good · Be unable to do your normal daily activities
    Free text: Pancreatitis unrelated
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-05-20
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-27
    Survey response — day 35, dose 2
    MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities
    Free text: I have felt overly tired every day for the last few weeks. ¯\_()_/¯
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-06-03
    Survey response — day 42, dose 2
    MedDRA: Oropharyngeal pain — Feeling: Fair
    Free text: I have a mild sore throat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-07-24
    Survey response — 3 months, dose 2
    MedDRA: Pancreatitis — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Pancreatitis
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  26. 2021-07-24
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  27. 2021-08-02
  28. 2021-10-21
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-12-05
    Dose 3 — Moderna
  30. 2021-12-05
    Health check-in — day 0, dose 3
    Feeling: Fair · Site: Pain · None
    Adult check-in
  31. 2021-12-06
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain, Swelling · Fatigue or tiredness, Abdominal pain
    Adult check-in
  32. 2021-12-07
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness, Abdominal pain
    Adult check-in
  33. 2021-12-08
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · None
    Adult check-in
  34. 2021-12-10
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · None
    Adult check-in
  35. 2021-12-12
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-12-19
    Survey response — day 14, dose 3
    MedDRA: Oropharyngeal pain — Feeling: Fair
    Free text: Sore throat
    MedDRA releases: 2024-11 · check-in free text available
  37. 2021-12-30
    Survey response — day 21, dose 3
    MedDRA: Nasopharyngitis — Feeling: Fair
    Free text: Mild cold symptoms
    MedDRA releases: 2024-11 · check-in free text available
  38. 2022-01-04
    Health check-in — day 28, dose 3
    Feeling: Fair
    Adult check-in
  39. 2022-01-11
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  40. 2022-01-17
    Survey response — day 42, dose 3
    MedDRA: Anxiety, Head discomfort, Oropharyngeal pain, Sinus headache — Feeling: Poor
    Free text: #NAME?
    MedDRA releases: 2024-11 · check-in free text available
  41. 2022-01-22
  42. 2022-03-06
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  43. 2022-12-05
    Health check-in — 12 months, dose 3
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-25Moderna
22021-04-22Moderna
32021-12-05Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-07-24 Unsuccessful

Free text

Release 6 — day 0, dose 1

2021-03-25

Systemic reaction (other): Increased sweating 10 mins after injection, lasting 45 mins total.

Release 6 — days 1–6 daily, dose 1

2021-03-27

Systemic reaction (other): Chills were experienced while in a 70°F room. No associated fever, only chills for an hour. Abdominal pain was diffuse, around Mcburney's point, and intermittently near the spleen.

2021-03-30

Systemic reaction (other): Yellow colored, US quarter sized rash(similar to bruising or jaundice yellow) at injection site appeared today.

2021-03-31

Systemic reaction (other): Yellow quarter sized "rash" at injection site still present

Release 7 — day 14, dose 1

2021-04-08

Symptoms: Have had indigestion and bloating issues

Release 8 — day 14, dose 2

2021-05-08

Symptoms: I had acute pancreatitis, unrelated to the vaccine.

Release 8 — day 21, dose 2

2021-05-16

Symptoms: Pancreatitis unrelated

Release 8 — day 35, dose 2

2021-05-27

Symptoms: I have felt overly tired every day for the last few weeks. ¯\_()_/¯

Release 8 — day 42, dose 2

2021-06-03

Symptoms: I have a mild sore throat

Release 9 — 3 months, dose 2

2021-07-24

Symptoms: Pancreatitis

Release 10 — day 14, dose 3

2021-12-19

Symptoms: Sore throat

Release 10 — day 21, dose 3

2021-12-30

Symptoms: Mild cold symptoms

Release 10 — day 42, dose 3

2022-01-17

Symptoms: #NAME?

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
SDAbdominal distension ✓ ✓ ✓
SDAnxiety · · ✓
SDDyspepsia ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHead discomfort · · ✓
SDNasopharyngitis · · ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPancreatitis ✓ ✓ ✓
SDSinus headache · · ✓
SROAbdominal pain ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROHyperhidrosis ✓ ✓ ✓
SROImmediate post-injection reaction ✓ ✓ ✓
SROInjection site bruising ✓ ✓ ✓
SROInjection site discolouration ✓ ✓ ✓
SROInjection site rash ✓ ✓ ✓

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

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