ZEY-11172-97254
2 vaccinations
8 coded responses
26 check-ins
8 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 945 / CA
- Registered
- 2021-02-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-09
Registered in v-safe
-
2021-02-09
Dose 1 — Moderna
- 2021-02-09
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2021-02-10
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Fair · Site: PainFree text: More pain in and around the injection site then I had Expected. Actually more pain below and towards the inner a area of the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Good · Site: PainFree text: Injection site and surrounding area is less painful todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
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2021-02-23
Survey response — day 14, dose 1MedDRA: Gastrointestinal disorder — Feeling: GoodFree text: Intestinal issues that started few days ago. Cannot say it is related to the shot as this is more then a week later. Eating the same things my wife is eating so cannot say this is food related either. Lasted three days so far but getting betterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
-
2021-03-09
Dose 2 — Moderna
- 2021-03-09
-
2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-12
- 2021-03-13
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity, Pruritus — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: Redness or rash not sure. It is between the deltoid/bicep/triceps. Sore to be slapped on or itch at.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Survey response — days 1–6 daily, dose 2MedDRA: Sensitive skin — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Skin sensitivity in thigh area inner leg groin area that doesnt show redness but feels like shingles. I have Already had shingle vaccine a year ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
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2021-04-13
Survey response — day 35, dose 2MedDRA: Diarrhoea, Gastrointestinal disorder — Feeling: GoodFree text: Experienced some lower intestinal issues and slight diarrhea. Nothing unusual was eaten and both my wife and I had The same food and she hasnt experienced anything. This has covered a couple of days only So farMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-20
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2021-06-08
Survey response — 3 months, dose 2MedDRA: Muscle discomfort, Thrombosis — 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 consultationFree text: Symptoms: Some pulled muscles which is unusual for me. Both hamstrings that lasted a day each then transferred to one calf muscle which has been bothersome for two weeks now. Id been walking 2-4 miles / day for mnths before this happened. Ruled out blood cl · Healthcare visit (other): Had sonogram done to rule out blood clot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-08
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-09-07
Survey response — 6 months, dose 2MedDRA: Fatigue, Neuralgia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Ive had nerve pain in entire left leg that has lasted for 3 months and counting. I do have some feeling of fatigue at certain times in the day. These things have started shortly after the vaccine and thought maybe tied to something else.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-21
-
2021-11-24
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-09 | Moderna | |
| 2 | 2021-03-09 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-08 | Successful 2021-11-24 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): More pain in and around the injection site then I had Expected. Actually more pain below and towards the inner a area of the injection site
Systemic reaction (other): Injection site and surrounding area is less painful today
Release 4 — day 14, dose 1
Symptoms: Intestinal issues that started few days ago. Cannot say it is related to the shot as this is more then a week later. Eating the same things my wife is eating so cannot say this is food related either. Lasted three days so far but getting better
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Redness or rash not sure. It is between the deltoid/bicep/triceps. Sore to be slapped on or itch at.
Systemic reaction (other): Skin sensitivity in thigh area inner leg groin area that doesnt show redness but feels like shingles. I have Already had shingle vaccine a year ago.
Release 7 — day 35, dose 2
Symptoms: Experienced some lower intestinal issues and slight diarrhea. Nothing unusual was eaten and both my wife and I had The same food and she hasnt experienced anything. This has covered a couple of days only So far
Release 8 — 3 months, dose 2
Symptoms: Some pulled muscles which is unusual for me. Both hamstrings that lasted a day each then transferred to one calf muscle which has been bothersome for two weeks now. Id been walking 2-4 miles / day for mnths before this happened. Ruled out blood cl
Healthcare visit (other): Had sonogram done to rule out blood clot.
Release 9 — 6 months, dose 2
Symptoms: Ive had nerve pain in entire left leg that has lasted for 3 months and counting. I do have some feeling of fatigue at certain times in the day. These things have started shortly after the vaccine and thought maybe tied to something else.
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 | Thrombosis | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SD | Muscle discomfort | ✓ | ✓ | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Sensitive skin | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release