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ZFC-19295-37763

5 vaccinations 4 coded responses 40 check-ins 4 free-text entries 1 call case
Sex
Male
Age at first dose
61-65
ZIP prefix
605 / IL
Registered
2021-03-13
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-10
    Dose 1 — Moderna
  2. 2021-03-10
    Dose 2 — Moderna
  3. 2021-03-13
    Registered in v-safe
  4. 2021-03-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Headache, Neck pain — Feeling: Good
    Free text: Had headache, misc pains and soreness around neck the day after the 2nd shot which went away the day after that.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Disturbance in attention, Neuropathy peripheral, Pre-existing disease, Reaction to previous exposure to any vaccine — Feeling: Good
    Free text: Neuropathy which is aggravated whenever I get a vaccine of any kind
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness, Nausea
    Adult check-in
  7. 2021-03-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  8. 2021-03-17
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-03-24
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-03-31
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-04-07
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-04-14
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-04-21
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-06-09
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-09-08
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-10-27
    Dose 3 — Moderna
  17. 2021-10-27
    Health check-in — day 0, dose 3
    Feeling: Good · None
    Adult check-in
  18. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  19. 2021-10-29
    Survey response — days 1–6 daily, dose 3
    MedDRA: Chills — Feeling: Good · Site: Pain
    Free text: The chills I got from the booster were new from what I experienced after dose 1 and 2
    MedDRA releases: 2024-11 · check-in free text available
  20. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  21. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  22. 2021-11-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  23. 2021-11-02
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  24. 2021-11-03
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  25. 2021-11-10
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  26. 2021-11-17
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  27. 2021-11-24
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  28. 2021-12-01
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  29. 2021-12-08
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  30. 2022-01-26
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  31. 2022-04-01
    Dose 4 — Moderna
  32. 2022-04-18
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  33. 2022-04-22
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  34. 2022-05-02
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  35. 2022-05-06
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  36. 2022-05-14
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  37. 2022-07-01
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  38. 2022-09-20
    Dose 5 — Moderna
  39. 2022-09-29
    Health check-in — day 7, dose 5
    Feeling: Good · None
    Adult check-in
  40. 2022-10-04
    Health check-in — day 14, dose 5
    Feeling: Good
    Adult check-in
  41. 2022-10-11
    Survey response — day 21, dose 5
    MedDRA: Bronchitis, Cough, Influenza like illness, Office visit, Sinusitis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Sinus infection and bronchitis along with coughing and flu like symptoms. I don't believe this is any way related to the covid booster vaccine. · Healthcare visit (other): Doctor visit
    MedDRA releases: 2024-11 · check-in free text available
  42. 2022-10-11
    Report sent to call center — day 21, dose 5
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  43. 2022-10-13
  44. 2022-10-18
    Health check-in — day 28, dose 5
    Feeling: Fair
    Adult check-in
  45. 2022-10-25
    Health check-in — day 35, dose 5
    Feeling: Fair
    Adult check-in
  46. 2022-11-01
    Health check-in — day 42, dose 5
    Feeling: Fair
    Adult check-in
  47. 2022-12-20
    Health check-in — 3 months, dose 5
    Feeling: Good
    Adult check-in
  48. 2023-03-21
    Health check-in — 6 months, dose 5
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-10Moderna
22021-03-10Moderna
32021-10-27Moderna No
42022-04-01Moderna No
52022-09-20Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2022-10-11 Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Had headache, misc pains and soreness around neck the day after the 2nd shot which went away the day after that.

2021-03-14

Systemic reaction (other): Neuropathy which is aggravated whenever I get a vaccine of any kind

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): The chills I got from the booster were new from what I experienced after dose 1 and 2

Release 12 — day 21, dose 5

2022-10-11

Symptoms: Sinus infection and bronchitis along with coughing and flu like symptoms. I don't believe this is any way related to the covid booster vaccine.
Healthcare visit (other): Doctor visit

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
HCVOOffice visit · · ✓
SDBronchitis · · ✓
SDCough · · ✓
SDInfluenza like illness · · ✓
SDSinusitis · · ✓
SROChills · · ✓
SRODisturbance in attention ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SRONeck pain ✓ ✓ ✓
SRONeuropathy peripheral ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROReaction to previous exposure to any vaccine ✓ ✓ ✓

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

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