ZNY-33002-49679
2 vaccinations
3 coded responses
7 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 285 / NC
- Registered
- 2021-06-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
XQG-19263-58830
Other · Male · 2021-06-13
Timeline
-
2021-05-15
Dose 1 — Moderna
-
2021-06-12
Dose 2 — Moderna
-
2021-06-13
Registered in v-safe
-
2021-06-13
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain — Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal painFree text: Severe abdominal pain. I have only had this a couple of times before. Had to take medicine prescribed by doctor to alleviate the pain to avoid going to ER.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-14
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend schoolAdult check-in
-
2021-06-16
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: SwellingFree text: Feeling much better!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-17
- 2021-06-19
- 2021-06-26
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2021-07-24
Survey response — day 42, dose 2MedDRA: Blood glucose decreased, Dizziness, Office visit — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I had a dizzy spell Thursday. Felt like I would pass out. When I saw my doctor in December, I was no longer pre-diabetic & my cholesterol had gone down 40 points. Now Im wearing a glucose sensor & having very low blood sugar readings around 50. · Healthcare visit (other): Regular doctors office visitMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-24
Report sent to call center — day 42, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-08-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-15 | Moderna | |
| 2 | 2021-06-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-24 | Unsuccessful |
Free text
Release 9 — days 1–6 daily, dose 2
Systemic reaction (other): Severe abdominal pain. I have only had this a couple of times before. Had to take medicine prescribed by doctor to alleviate the pain to avoid going to ER.
Systemic reaction (other): Feeling much better!
Release 9 — day 42, dose 2
Symptoms: I had a dizzy spell Thursday. Felt like I would pass out. When I saw my doctor in December, I was no longer pre-diabetic & my cholesterol had gone down 40 points. Now Im wearing a glucose sensor & having very low blood sugar readings around 50.
Healthcare visit (other): Regular doctors office visit
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 | Blood glucose decreased | ✓ | · | ✓ |
| SD | Dizziness | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Therapeutic response unexpected | ○ | · | ○ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release