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ZKN-24346-84480

2 vaccinations 5 coded responses 18 check-ins 5 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
300 / GA
Registered
2021-02-06
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-05
    Dose 1 — Moderna
  2. 2021-02-06
    Registered in v-safe
  3. 2021-02-06
    Survey response — days 1–6 daily, dose 1
    MedDRA: No adverse event — Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches · Be unable to do your normal daily activities
    Free text: None
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-02-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Swelling · None
    Adult check-in
  6. 2021-02-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-12
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-19
    Survey response — day 14, dose 1
    MedDRA: Deep vein thrombosis, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Blood clot in my right leg since Saturday · Healthcare visit (other): Doctor appointment then to Vascular surgeon for sonogram
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-19
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  11. 2021-02-26
    Survey response — day 21, dose 1
    MedDRA: Pain, Thrombosis — Feeling: Fair
    Free text: Blood clots in my leg below my skin, not in my vein. Clot has gone down in my calf and has seen to go down to my ankle. Is not as sore as it was yesterday.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-05
    Dose 2 — Moderna
  13. 2021-03-05
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-03-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-03-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-03-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-03-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  19. 2021-03-21
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-03-26
    Survey response — day 21, dose 2
    MedDRA: Paraesthesia — Feeling: Good
    Free text: Legs tingling
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-04-17
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-08-09
  23. 2021-08-10
  24. 2021-08-11
  25. 2021-08-11
  26. 2021-09-06
    Survey response — 6 months, dose 2
    MedDRA: Limb mass, Lipoma, Office visit, Paraesthesia — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Legs tingles some time. · Healthcare visit (other): Dr. Visit. Had an ultrasound on my legs to see if blood clots were back. No blood clots but had a mass behind my right knee that they said was fatty tissue.
    MedDRA releases: 2024-11 · check-in free text available
  27. 2021-09-06
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  28. 2021-09-07

Vaccinations

DoseDateManufacturerCo-administered
12021-02-05Moderna
22021-03-05Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-02-19 Successful
2021-08-11
2021-09-06 Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-06

Systemic reaction (other): None

Release 4 — day 14, dose 1

2021-02-19

Symptoms: Blood clot in my right leg since Saturday
Healthcare visit (other): Doctor appointment then to Vascular surgeon for sonogram

Release 4 — day 21, dose 1

2021-02-26

Symptoms: Blood clots in my leg below my skin, not in my vein. Clot has gone down in my calf and has seen to go down to my ankle. Is not as sore as it was yesterday.

Release 6 — day 21, dose 2

2021-03-26

Symptoms: Legs tingling

Release 9 — 6 months, dose 2

2021-09-06

Symptoms: Legs tingles some time.
Healthcare visit (other): Dr. Visit. Had an ultrasound on my legs to see if blood clots were back. No blood clots but had a mass behind my right knee that they said was fatty tissue.

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
HCVOLimb mass · · ✓
HCVOLipoma · · ✓
HCVOOffice visit ✓ ✓ ✓
SDDeep vein thrombosis ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDParaesthesia ✓ ✓ ✓
SDThrombosis ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓

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

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