ZMS-68474-96065
3 vaccinations
4 coded responses
28 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 593 / MT
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Registered in v-safe
-
2021-01-25
Dose 1 — Moderna
- 2021-01-25
-
2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Fair · Site: PainFree text: My arm briefly went numb. I was driving and had the arm with the shot elevated, then it got tingly after awhile. I put it back down and drove with my other hand and it was fine after about 5 minutes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-27
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal pain — Feeling: Good · Site: PainFree text: A mild sore throat set in last night. Its not too bad.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-01-29
- 2021-01-31
- 2021-02-01
- 2021-02-08
- 2021-02-16
- 2021-02-22
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal painAdult check-in
-
2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Nausea — Feeling: Good · Site: Pain · Fever · Chills, NauseaFree text: Started the day with chills and bad nausea, by the end of the day, i was pretty much good.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Fatigue or tiredness, NauseaAdult check-in
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-18
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-05-26
- 2021-08-25
-
2021-12-01
Dose 3 — Moderna
-
2022-02-24
Survey response — 12 months, dose 2MedDRA: Gallbladder operation, Gallbladder rupture, Hospitalisation, Near death experience — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: My gall bladder exploded, i almost died. I was in surgery for 6 hours, and 3 days in the hospital.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-24
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-03-02
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-04
- 2022-12-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-12-01 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-24 | Successful 2022-03-02 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): My arm briefly went numb. I was driving and had the arm with the shot elevated, then it got tingly after awhile. I put it back down and drove with my other hand and it was fine after about 5 minutes.
Systemic reaction (other): A mild sore throat set in last night. Its not too bad.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Started the day with chills and bad nausea, by the end of the day, i was pretty much good.
Release 11 — 12 months, dose 2
Symptoms: My gall bladder exploded, i almost died. I was in surgery for 6 hours, and 3 days in the hospital.
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 | Gallbladder operation | · | · | ✓ |
| SD | Gallbladder rupture | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Near death experience | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release