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ZLJ-13240-36557

1 vaccination 3 coded responses 7 check-ins 3 free-text entries 3 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
329 / FL
Registered
2021-03-28
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-05
    Dose 1 — Moderna
  2. 2021-03-28
    Registered in v-safe
  3. 2021-03-28
    Survey response — day 21, dose 1
    MedDRA: Decreased appetite, Diarrhoea, Pain — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Severe body aches & pain, no appetite, watery diarrhea. SOB
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-28
    Report sent to call center — day 21, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  5. 2021-04-02
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-04-09
    Survey response — day 35, dose 1
    MedDRA: Cough, Decreased appetite, Diarrhoea, Hospitalisation, Myalgia, SARS-CoV-2 test positive — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization
    Free text: Covid diarrhea. Tested positive 3/15, hospitalized until 3/20. Had cough, muscle aches & pain, loss of appetite + the diarrhea. Can't have second dose until I have 2 negative tests.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-09
    Report sent to call center — day 35, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  8. 2021-04-16
    Health check-in — day 42, dose 1
    Feeling: Fair
    Adult check-in
  9. 2021-06-04
    Health check-in — 3 months, dose 1
    Feeling: Fair
    Adult check-in
  10. 2021-09-03
    Survey response — 6 months, dose 1
    MedDRA: COVID-19, Diabetes mellitus, Hospitalisation, Office visit, Vulval ulceration — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Diabetic ulcers on labia. I've had them since late February/early March but didn't get diagnosed until late April/early May. I am being treated at wound care center in (b)(6). · Healthcare visit (other): Had to wait about 2 weeks post Covid hospitalization to see doctor in person for diagnosis.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  11. 2021-09-03
    Report sent to call center — 6 months, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  12. 2021-09-08
  13. 2022-03-05
    Health check-in — 12 months, dose 1
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-05Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-03-28 Unsuccessful
2021-04-09 Unsuccessful
2021-09-03 Unsuccessful

Free text

Release 6 — day 21, dose 1

2021-03-28

Symptoms: Severe body aches & pain, no appetite, watery diarrhea. SOB

Release 7 — day 35, dose 1

2021-04-09

Symptoms: Covid diarrhea. Tested positive 3/15, hospitalized until 3/20. Had cough, muscle aches & pain, loss of appetite + the diarrhea. Can't have second dose until I have 2 negative tests.

Release 9 — 6 months, dose 1

2021-09-03

Symptoms: Diabetic ulcers on labia. I've had them since late February/early March but didn't get diagnosed until late April/early May. I am being treated at wound care center in (b)(6).
Healthcare visit (other): Had to wait about 2 weeks post Covid hospitalization to see doctor in person for diagnosis.
redacted (b)(6)

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
HCVOCOVID-19 ✓ · ✓
HCVOHospitalisation ✓ · ✓
SDCough ✓ ✓ ✓
SDDecreased appetite ✓ ✓ ✓
SDDiabetes mellitus ✓ · ✓
SDDiarrhoea ✓ ✓ ✓
SDHospitalisation ✓ ✓ ✓
SDMyalgia ✓ ✓ ✓
SDOffice visit ✓ · ✓
SDPain ✓ ✓ ✓
SDSARS-CoV-2 test positive ✓ ✓ ✓
SDVulval ulceration ✓ · ✓

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