ZH6-28539-71575
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 600 / IL
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Dose 1 — Moderna
-
2021-01-30
Registered in v-safe
-
2021-01-30
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Right side of the jaw having some pain. May be related to a recent cleaning 4 days ago but didn't feel this way until today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
-
2021-02-01
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction, Office visit — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, 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: Systemic reaction (other): Right hand side of the jaw can't handle any pressure. · Healthcare visit (other): Scheduled a visit for tomorrow.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-01
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-02
Survey response — days 1–6 daily, dose 1MedDRA: Office visit, Oral pain — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Mouth pain was likely an impacted tooth · Healthcare visit (other): Visited dentist and was referred to an endodontist.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-02
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-03
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: FairFree text: Dental issuing is still ongoing without resolution.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Oral pain — Feeling: GoodFree text: Started antibiotics for my mouth pain, visiting an endodontist next week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
- 2021-02-12
- 2021-02-19
-
2021-02-26
Dose 2 — Moderna
- 2021-02-26
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tirednessAdult check-in
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-05-28
- 2021-06-14
- 2021-08-27
- 2022-02-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Moderna | |
| 2 | 2021-02-26 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-01 | Unsuccessful | |
| 2021-02-02 | Unsuccessful |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Right side of the jaw having some pain. May be related to a recent cleaning 4 days ago but didn't feel this way until today.
Systemic reaction (other): Right hand side of the jaw can't handle any pressure.
Healthcare visit (other): Scheduled a visit for tomorrow.
Systemic reaction (other): Mouth pain was likely an impacted tooth
Healthcare visit (other): Visited dentist and was referred to an endodontist.
Systemic reaction (other): Dental issuing is still ongoing without resolution.
Systemic reaction (other): Started antibiotics for my mouth pain, visiting an endodontist next week.
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 | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Oral pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release