ZMV-11162-47737
2 vaccinations
3 coded responses
17 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 782 / TX
- Registered
- 2021-03-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-05
Dose 1 — Moderna
-
2021-03-23
Registered in v-safe
-
2021-03-23
Survey response — day 14, dose 1MedDRA: Chills, Loss of personal independence in daily activities, Pre-existing disease, Sciatica — Feeling: Good · Be unable to do your normal daily activitiesFree text: Had mild chills on 03/12. Was having sciatic issues priorvand pain got worse. Unable to do routine housework due to sciatic pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
-
2021-04-02
Dose 2 — Moderna
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
-
2021-04-09
Survey response — day 7, dose 2MedDRA: Office visit, Pre-existing disease, Sciatica — Feeling: Poor · Muscle or body aches · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): I dont know if it had anything to do with it but After about eight days when I got the vaccine my sciatica pain got extremely worse. Could it have anything to do with it? I am still in pain I dont know if its vaccine related or not. · Healthcare visit (other): Doctors visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-09
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-16
- 2021-04-24
- 2021-05-02
- 2021-05-07
- 2021-05-17
- 2021-07-04
- 2022-02-17
-
2022-04-02
Survey response — 12 months, dose 2MedDRA: Squamous cell carcinoma of skin — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Squamous cell carcinoma on back of leg.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-02
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-09 | Unsuccessful | |
| 2022-04-02 | Unsuccessful |
Free text
Release 6 — day 14, dose 1
Symptoms: Had mild chills on 03/12. Was having sciatic issues priorvand pain got worse. Unable to do routine housework due to sciatic pain.
Release 7 — day 7, dose 2
Systemic reaction (other): I dont know if it had anything to do with it but After about eight days when I got the vaccine my sciatica pain got extremely worse. Could it have anything to do with it? I am still in pain I dont know if its vaccine related or not.
Healthcare visit (other): Doctors visit
Release 11 — 12 months, dose 2
Symptoms: Squamous cell carcinoma on back of leg.
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 | Chills | ✓ | ✓ | ✓ |
| SD | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Sciatica | ✓ | ✓ | ✓ |
| SD | Squamous cell carcinoma of skin | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Sciatica | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release