ZF6-12803-66391
3 vaccinations
6 coded responses
34 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 463 / IN
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Registered in v-safe
-
2021-01-11
Dose 1 — Moderna
- 2021-01-15
-
2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-01-18
- 2021-01-25
- 2021-02-02
-
2021-02-08
Dose 2 — Moderna
- 2021-02-08
-
2021-02-09
Survey response — days 1–6 daily, dose 2MedDRA: Nausea — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: Nausea VERY slightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
-
2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-05-10
- 2021-08-09
-
2021-10-28
Dose 3 — Moderna
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Limb discomfort — Feeling: Good · Site: Redness, SwellingFree text: Heaviness (fluid?) in armpit of injected arm.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Swelling — Feeling: GoodFree text: Feels like swelling of latissimus dorsi of injection armMedDRA releases: 2024-11 · check-in free text available
-
2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Headache, Neck pain — Feeling: Good · Headache, Joint painsFree text: Neck pain likely unrelated to vaccine,HA is very slight and due yo neck painMedDRA releases: 2024-11 · check-in free text available
- 2021-11-03
- 2021-11-04
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2021-11-11
Survey response — day 14, dose 3MedDRA: Cough, Influenza virus test negative, Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Initial 24hr sore throat, dry cough, then stuffy runny nose/dry cough. No fever. No trouble breathing. COVID, Flu, Strep tests all negative Still have cold symptomsMedDRA releases: 2024-11 · check-in free text available
-
2021-11-11
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-11-12
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
-
2022-01-27
Survey response — 3 months, dose 3MedDRA: Nasal discomfort, Nasal dryness — Feeling: GoodFree text: Slight dryness and burning of upper nasal passages.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-28
- 2022-10-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-11 | Successful 2021-11-12 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Nausea VERY slight
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Heaviness (fluid?) in armpit of injected arm.
Systemic reaction (other): Feels like swelling of latissimus dorsi of injection arm
Systemic reaction (other): Neck pain likely unrelated to vaccine,HA is very slight and due yo neck pain
Release 10 — day 14, dose 3
Symptoms: Initial 24hr sore throat, dry cough, then stuffy runny nose/dry cough. No fever. No trouble breathing. COVID, Flu, Strep tests all negative Still have cold symptoms
Release 11 — 3 months, dose 3
Symptoms: Slight dryness and burning of upper nasal passages.
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 |
|---|---|---|---|---|
| SD | Cough | · | · | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasal discomfort | · | · | ✓ |
| SD | Nasal dryness | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Limb discomfort | · | · | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Neck pain | · | · | ✓ |
| SRO | Swelling | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release