ZKW-13156-75199
4 vaccinations
5 coded responses
34 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 921 / CA
- Registered
- 2021-01-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Registered in v-safe
-
2021-01-19
Dose 1 — Moderna
- 2021-01-20
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-02-23
-
2021-02-24
Dose 2 — Moderna
-
2021-02-24
Health check-in — day 0, dose 2Feeling: Fair · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-05-26
-
2021-08-25
Survey response — 6 months, dose 2MedDRA: Fatigue, Hypersomnia, Malaise, Pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: Strong reaction to my second shingles vaccination on 7/30/21: several days of general body aches, very tired/sleeping a lot, general malaise.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-11-06
Dose 3 — Moderna
-
2022-02-24
Survey response — 12 months, dose 2MedDRA: Chest discomfort, Fatigue, Oropharyngeal pain, Paranasal sinus hypersecretion, SARS-CoV-2 test negative, Sneezing — Feeling: Good · Be unable to do your normal daily activitiesFree text: Sore throat, sneezing, draining sinuses, upper chest tightness, tiredness - lasted three weeks. 'Took a home rapid Covid test - negative. After another week of continuing symptoms, 'got a (b)(6) site's PCR test. It was also negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-31
Dose 4 — Moderna
- 2022-04-24
-
2022-04-28
Survey response — day 28, dose 4MedDRA: Chills, Fatigue, Nasopharyngitis, Oropharyngeal pain, Productive cough, SARS-CoV-2 test negative, Secretion discharge, Sneezing, Sputum discoloured — Feeling: Poor · Be unable to do your normal daily activitiesFree text: I had negative Covid test on 4/21 for reentry into U.S. from Austria. Yesterday, 4/28, I started head cold symptoms, sore throat and excessive sneezing. Today, I am coughing up yellow mucus, have chills, and am very tired. A home Covid test is negatiMedDRA releases: 2024-11 · check-in free text available
- 2022-05-05
-
2022-05-12
Survey response — day 42, dose 4MedDRA: SARS-CoV-2 test negative, Sinusitis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sinus infection. Have had 3 Covid tests in 3 weeks - all negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-12
Report sent to call center — day 42, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-05-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-06-30
-
2022-09-29
Survey response — 6 months, dose 4MedDRA: SARS-CoV-2 test positive, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: I tested positive for Covid on 9/12/22 · Healthcare visit (other): My doctor prescribed an infusion of monoclonal antibodies which I got on 9/12/22.MedDRA releases: 2024-11 · check-in free text available
-
2022-09-29
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-09-30
- 2023-04-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-11-06 | Moderna | No |
| 4 | 2022-03-31 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-12 | Successful 2022-05-13 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-09-29 | Unsuccessful |
Free text
Release 9 — 6 months, dose 2
Symptoms: Strong reaction to my second shingles vaccination on 7/30/21: several days of general body aches, very tired/sleeping a lot, general malaise.
Release 11 — 12 months, dose 2
Symptoms: Sore throat, sneezing, draining sinuses, upper chest tightness, tiredness - lasted three weeks. 'Took a home rapid Covid test - negative. After another week of continuing symptoms, 'got a (b)(6) site's PCR test. It was also negative.
redacted (b)(6)
Release 11 — day 28, dose 4
Symptoms: I had negative Covid test on 4/21 for reentry into U.S. from Austria. Yesterday, 4/28, I started head cold symptoms, sore throat and excessive sneezing. Today, I am coughing up yellow mucus, have chills, and am very tired. A home Covid test is negati cut off by CDC
Release 11 — day 42, dose 4
Symptoms: Sinus infection. Have had 3 Covid tests in 3 weeks - all negative.
Release 12 — 6 months, dose 4
Symptoms: I tested positive for Covid on 9/12/22
Healthcare visit (other): My doctor prescribed an infusion of monoclonal antibodies which I got on 9/12/22.
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 | Unevaluable event | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Hypersomnia | ✓ | · | ✓ |
| SD | Malaise | ✓ | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | ✓ | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Secretion discharge | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Sputum discoloured | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release