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
-
2021-03-05
Dose 1 — Moderna
-
2021-03-28
Registered in v-safe
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2021-03-28
Survey response — day 21, dose 1MedDRA: Decreased appetite, Diarrhoea, Pain — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Severe body aches & pain, no appetite, watery diarrhea. SOBMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-28
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-02
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2021-04-09
Survey response — day 35, dose 1MedDRA: 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, HospitalizationFree 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
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2021-04-09
Report sent to call center — day 35, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-16
- 2021-06-04
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2021-09-03
Survey response — 6 months, dose 1MedDRA: COVID-19, Diabetes mellitus, Hospitalisation, Office visit, Vulval ulceration — Feeling: Good · Get care from a doctor or other healthcare professionalFree 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
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2021-09-03
Report sent to call center — 6 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-08
- 2022-03-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-28 | Unsuccessful | |
| 2021-04-09 | Unsuccessful | |
| 2021-09-03 | Unsuccessful |
Free text
Release 6 — day 21, dose 1
Symptoms: Severe body aches & pain, no appetite, watery diarrhea. SOB
Release 7 — day 35, dose 1
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | COVID-19 | ✓ | · | ✓ |
| HCVO | Hospitalisation | ✓ | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Diabetes mellitus | ✓ | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
| SD | Vulval ulceration | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release