ZKR-67141-73466
2 vaccinations
4 coded responses
21 check-ins
4 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 972 / OR
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-13
Registered in v-safe
-
2021-01-13
Dose 1 — Moderna
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2021-01-13
Survey response — day 0, dose 1MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Slight dizziness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · None · Be unable to do your normal daily activitiesAdult check-in
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2021-01-14
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2021-01-15
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-15
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-22
- 2021-01-27
- 2021-02-03
- 2021-02-10
-
2021-02-12
Dose 2 — Moderna
- 2021-02-17
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
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2021-03-19
Survey response — day 35, dose 2MedDRA: Asthma, Cough, Seasonal allergy, Wheezing — Feeling: GoodFree text: Increase in pre-existing asthma symptoms (e.g., coughing, wheezing). Could have been triggered by seasonal allergies, however.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
- 2021-05-14
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2021-08-13
Survey response — 6 months, dose 2MedDRA: Headache, Paranasal sinus discomfort — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sinus pressure and headache. Possible sniffles.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2022-02-14
Survey response — 12 months, dose 2MedDRA: Mechanical urticaria, Self-medication, Urticaria — Feeling: Poor · Be unable to work or attend school, 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: Daily, full-body hives (urticaria) and dermatographia. Onset of symptoms occurred about 10 days post-Moderna booster shot (half-dose), and have continued to-date for approximately 2.5 months. Hives require a daily antihistamine (Zyrtec) to mitigate.MedDRA releases: 2024-11 · check-in free text available
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2022-02-14
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-02-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-14 | priority 2/3 | |
| 2021-01-15 | priority 2/3 | |
| 2022-02-14 | Unsuccessful |
Free text
Release 1 — day 0, dose 1
Systemic reaction (other): Slight dizziness.
Release 5 — day 35, dose 2
Symptoms: Increase in pre-existing asthma symptoms (e.g., coughing, wheezing). Could have been triggered by seasonal allergies, however.
Release 9 — 6 months, dose 2
Symptoms: Sinus pressure and headache. Possible sniffles.
Release 11 — 12 months, dose 2
Symptoms: Daily, full-body hives (urticaria) and dermatographia. Onset of symptoms occurred about 10 days post-Moderna booster shot (half-dose), and have continued to-date for approximately 2.5 months. Hives require a daily antihistamine (Zyrtec) to mitigate. 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 |
|---|---|---|---|---|
| SD | Asthma | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Mechanical urticaria | · | · | ✓ |
| SD | Paranasal sinus discomfort | ✓ | · | ✓ |
| SD | Seasonal allergy | ✓ | ✓ | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SD | Wheezing | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release