ZFE-15096-74091
5 vaccinations
8 coded responses
43 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 010 / MA
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Dose 1 — Moderna
-
2021-02-04
Registered in v-safe
-
2021-02-04
Dose 2 — Moderna
- 2021-02-04
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-07
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
- 2021-02-27
- 2021-03-04
- 2021-03-13
- 2021-05-06
- 2021-08-07
-
2021-10-29
Dose 3 — Moderna
- 2021-10-29
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-31
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Back pain — Feeling: GoodFree text: back pain but I feel unrelatedMedDRA releases: 2024-11 · check-in free text available
- 2021-11-02
-
2021-11-07
Survey response — day 7, dose 3MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2021-11-12
- 2021-11-19
-
2021-11-26
Survey response — day 28, dose 3MedDRA: Rash, Urticaria — Feeling: GoodFree text: Intermittent rash/hivesMedDRA releases: 2024-11 · check-in free text available
-
2021-12-04
Survey response — day 35, dose 3MedDRA: Office visit, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Unrelated Urticaria · Healthcare visit (other): In person PCP visitMedDRA releases: 2024-11 · check-in free text available
-
2021-12-04
Report sent to call center — day 35, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-12-08
- 2021-12-16
- 2022-01-30
-
2022-04-21
Dose 4 — Moderna
-
2022-04-22
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-04-28
- 2022-05-05
-
2022-05-14
Survey response — day 21, dose 4MedDRA: Allergic respiratory symptom, Myalgia, Throat irritation — Feeling: FairFree text: I had a close contact from a colleague who tested positive. I feel allergy sxs, scratchy throat and significant muscle aches. I am day 4 post exposure. 2 neg Pcrs and a negative antigen test this morning. Fully vaccinated +2boostersMedDRA releases: 2024-11 · check-in free text available
-
2022-05-19
Survey response — day 28, dose 4MedDRA: Cough, Decreased appetite, Headache, Malaise, Oxygen saturation decreased, Pain, Pyrexia — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: body aches, headaches, cough, fever, loss of appetite - low o then levels · Healthcare visit (other): Sx concerns w COVID - prescribed PaxlovidMedDRA releases: 2024-11 · check-in free text available
-
2022-05-19
Report sent to call center — day 28, dose 4Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-05-20
- 2022-05-20
-
2022-05-20
Call successfulDoes not wish to fill out VAERS report
-
2022-05-20
Call successfulCompleted over the phone
- 2022-05-27
- 2022-07-24
-
2022-09-30
Dose 5 — Moderna
- 2022-10-03
-
2022-10-06
Survey response — days 1–6 daily, dose 5MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2022-10-08
Survey response — day 7, dose 5MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2022-10-16
- 2022-10-21
- 2022-10-29
- 2022-11-04
- 2022-11-11
- 2022-12-30
- 2023-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-04-21 | Moderna | No |
| 5 | 2022-09-30 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-04 | Successful 2022-05-20 |
Does not wish to fill out VAERS report |
| 2022-05-19 | Successful 2022-05-20 |
Completed over the phone |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): back pain but I feel unrelated
Release 10 — day 7, dose 3
Systemic reaction (other): No
Release 10 — day 28, dose 3
Symptoms: Intermittent rash/hives
Release 10 — day 35, dose 3
Release 11 — day 21, dose 4
Symptoms: I had a close contact from a colleague who tested positive. I feel allergy sxs, scratchy throat and significant muscle aches. I am day 4 post exposure. 2 neg Pcrs and a negative antigen test this morning. Fully vaccinated +2boosters
Release 11 — day 28, dose 4
Symptoms: body aches, headaches, cough, fever, loss of appetite - low o then levels
Healthcare visit (other): Sx concerns w COVID - prescribed Paxlovid
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): No
Release 12 — day 7, dose 5
Systemic reaction (other): No
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 | Malaise | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Allergic respiratory symptom | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Oxygen saturation decreased | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Back pain | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release