ZL7-25521-61638
2 vaccinations
3 coded responses
17 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 060 / CT
- Registered
- 2021-04-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-05
Dose 1 — Moderna
-
2021-04-06
Registered in v-safe
-
2021-04-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-07
- 2021-04-08
- 2021-04-10
- 2021-04-11
-
2021-04-12
Health check-in — day 7, dose 1Feeling: Fair · Site: Pain, Redness, Swelling, Itching · HeadacheAdult check-in
-
2021-04-19
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site rash — Feeling: FairFree text: Itchy rash on arm at injection site the was red and raised. Became larger over coupke of days spreading down and around arm with leading edge more red and raised. Subsiding now, starting at site of injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-26
-
2021-05-04
Dose 2 — Moderna
- 2021-05-04
-
2021-05-10
Survey response — days 1–6 daily, dose 2MedDRA: Injection site bruising — Feeling: Good · Site: Pain, Redness, Swelling · Headache, Muscle or body achesFree text: Bruise at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-02
- 2021-08-03
- 2021-11-05
-
2022-05-04
Survey response — 12 months, dose 2MedDRA: Cough, Nasopharyngitis, Office visit, Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Just colds, lots of congestion and coughing. my 1 yr old is in daycare · Healthcare visit (other): PCP regular apptMedDRA releases: 2024-11 · check-in free text available
-
2022-05-04
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2022-05-05
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-05 | Moderna | |
| 2 | 2021-05-04 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-04 | Successful 2022-05-05 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 7 — day 14, dose 1
Symptoms: Itchy rash on arm at injection site the was red and raised. Became larger over coupke of days spreading down and around arm with leading edge more red and raised. Subsiding now, starting at site of injection.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Bruise at injection site
Release 11 — 12 months, dose 2
Symptoms: Just colds, lots of congestion and coughing. my 1 yr old is in daycare
Healthcare visit (other): PCP regular appt
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 | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release