ZGX-28923-40106
3 vaccinations
7 coded responses
38 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 970 / OR
- Registered
- 2021-02-10
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-02-10
Registered in v-safe
-
2021-02-10
Dose 1 — Moderna
- 2021-02-10
-
2021-02-11
Survey response — days 1–6 daily, dose 1MedDRA: Cardiac disorder — Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body achesFree text: My heart feels funny but it might be the weather...MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Sensitivity to weather change — Feeling: Good · HeadacheFree text: The weather is bad probably the reason for the headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
-
2021-03-10
Dose 2 — Moderna
- 2021-03-10
-
2021-03-11
Survey response — days 1–6 daily, dose 2MedDRA: Angina pectoris, Pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaFree text: My heart hurts again dull painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Survey response — days 1–6 daily, dose 2MedDRA: Chest pain — Feeling: GoodFree text: Chest pain at sternumMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
-
2021-03-24
Survey response — day 14, dose 2MedDRA: Back pain, Office visit — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Lower back pain! (But I do have a physical job) · Healthcare visit (other): ChiropractorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Report sent to call center — day 14, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-06-09
- 2021-09-08
-
2021-10-22
Dose 3 — Moderna
-
2021-10-25
Survey response — days 1–6 daily, dose 3MedDRA: Dyspnoea — Feeling: Good · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessFree text: Shortness of breathMedDRA releases: 2024-11 · check-in free text available
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-28
- 2021-12-03
- 2022-01-21
-
2022-03-07
Call successfulParticipant prefers to complete VAERS report online
- 2022-04-22
-
2022-10-22
Survey response — 12 months, dose 3MedDRA: Alopecia, Brain fog, Chest pain, Memory impairment, Pre-existing disease — Feeling: FairFree text: The week after my shot it I noticed a lot of hair in my comb and that was not normal. Also my chest hurt. Also my brain is foggy and I keep forgetting things. I'm a long hall sufferer from the first infection in 2020. I Don't have health insurance..MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | |
| 2 | 2021-03-10 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-24 | Successful 2022-03-07 |
Participant prefers to complete VAERS report online |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): My heart feels funny but it might be the weather...
Systemic reaction (other): The weather is bad probably the reason for the headache
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): My heart hurts again dull pain
Systemic reaction (other): Chest pain at sternum
Release 6 — day 14, dose 2
Symptoms: Lower back pain! (But I do have a physical job)
Healthcare visit (other): Chiropractor
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Shortness of breath
Release 12 — 12 months, dose 3
Symptoms: The week after my shot it I noticed a lot of hair in my comb and that was not normal. Also my chest hurt. Also my brain is foggy and I keep forgetting things. I'm a long hall sufferer from the first infection in 2020. I Don't have health insurance.. cut off by CDC
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Alopecia | · | · | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Memory impairment | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Angina pectoris | ✓ | ✓ | ✓ |
| SRO | Cardiac disorder | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Sensitivity to weather change | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release