ZKA-80679-49031
2 vaccinations
5 coded responses
22 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 379 / TN
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-30
Dose 1 — Moderna
-
2021-04-01
Registered in v-safe
-
2021-04-01
Survey response — days 1–6 daily, dose 1MedDRA: Decreased appetite, Dry mouth, Dysgeusia — Feeling: Fair · Site: Redness, Swelling · Fatigue or tirednessFree text: Reduced appetite, dry mouth, and metallic sort of taste in mouth.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-02
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness · Fatigue or tirednessAdult check-in
- 2021-04-03
-
2021-04-04
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue, Loss of personal independence in daily activities — Feeling: GoodFree text: Update: Previously reported fatigue did actually interfere with my daily activities.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-04-27
-
2021-05-02
Dose 2 — Moderna
-
2021-05-04
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Fatigue, Injection site pain, Joint range of motion decreased, Pain, Pain in extremity, Pyrexia — Feeling: Good · Site: Pain, Redness, Swelling · Be unable to do your normal daily activitiesFree text: Approximately 8 hours post-vaccine I experienced extreme fatigue, moderate chills, mild fever, severe arm pain at injection site, and severe reduction of range of motion in that arm. These issues lasted approximately 24 hours from onset.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-05
- 2021-05-06
- 2021-05-07
- 2021-05-08
- 2021-05-09
-
2021-05-16
Survey response — day 14, dose 2MedDRA: Myalgia — Feeling: GoodFree text: Some muscle aches for a few days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-23
- 2021-05-30
- 2021-06-06
- 2021-06-13
- 2021-08-01
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2021-10-31
Survey response — 6 months, dose 2MedDRA: Chills, Fatigue, Oropharyngeal pain, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Chills, tiredness, sore throat, congestion, sniffling, achy. · Healthcare visit (other): COVID-19 testMedDRA releases: 2024-11 · check-in free text available
-
2021-10-31
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-30 | Moderna | |
| 2 | 2021-05-02 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-31 | Unsuccessful |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Reduced appetite, dry mouth, and metallic sort of taste in mouth.
Systemic reaction (other): Update: Previously reported fatigue did actually interfere with my daily activities.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Approximately 8 hours post-vaccine I experienced extreme fatigue, moderate chills, mild fever, severe arm pain at injection site, and severe reduction of range of motion in that arm. These issues lasted approximately 24 hours from onset.
Release 8 — day 14, dose 2
Symptoms: Some muscle aches for a few days.
Release 10 — 6 months, dose 2
Symptoms: Chills, tiredness, sore throat, congestion, sniffling, achy.
Healthcare visit (other): COVID-19 test
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 | SARS-CoV-2 test | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Joint range of motion decreased | ✓ | ✓ | ✓ |
| SRO | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release