ZLW-23867-07455
4 vaccinations
5 coded responses
32 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 606 / IL
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-22
Dose 1 — Moderna
-
2021-01-30
Registered in v-safe
-
2021-01-30
Survey response — day 7, dose 1MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: Delayed reaction. 7 days after vaccine- red, itchy, swelling at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
-
2021-02-12
Survey response — day 21, dose 1MedDRA: Ear infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Ear infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-12
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-19
Dose 2 — Moderna
- 2021-02-19
-
2021-02-20
Survey response — days 1–6 daily, dose 2MedDRA: Herpes zoster — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessFree text: I got Shingles on my face/ ear 2 weeks ago. It has not completely resolved.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-22
-
2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: GoodFree text: Ive had a swollen lymph node in the armpit since my 2nd vaccine. Its slowly going away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-05-21
- 2021-07-30
- 2021-08-20
-
2021-11-18
Dose 3 — Moderna
- 2022-02-19
- 2022-05-19
-
2022-11-03
Dose 4 — Moderna
- 2022-11-04
- 2022-11-05
- 2022-11-06
- 2022-11-07
- 2022-11-08
- 2022-11-10
- 2022-11-17
- 2022-11-24
-
2022-12-01
Survey response — day 28, dose 4MedDRA: Cough, Pyrexia, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend schoolFree text: I had fever and slight cough. Neg at home COVID test.MedDRA releases: 2024-11 · check-in free text available
- 2022-12-08
- 2022-12-15
- 2023-02-02
- 2023-05-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-19 | Moderna | |
| 3 | 2021-11-18 | Moderna | No |
| 4 | 2022-11-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-12 | Unsuccessful |
Free text
Release 3 — day 7, dose 1
Systemic reaction (other): Delayed reaction. 7 days after vaccine- red, itchy, swelling at injection site
Release 4 — day 21, dose 1
Symptoms: Ear infection
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): I got Shingles on my face/ ear 2 weeks ago. It has not completely resolved.
Systemic reaction (other): Ive had a swollen lymph node in the armpit since my 2nd vaccine. Its slowly going away.
Release 12 — day 28, dose 4
Symptoms: I had fever and slight cough. Neg at home COVID test.
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 | Cough | · | · | ✓ |
| SD | Ear infection | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Herpes zoster | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release