ZPC-13676-60751
3 vaccinations
5 coded responses
35 check-ins
5 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 934 / CA
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Moderna
- 2021-01-14
- 2021-01-15
- 2021-01-16
-
2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Myalgia — Feeling: Good · Muscle or body achesFree text: The muscle pain is around the inside of the left elbow. Got the jab in the left arm. Dont remember doing anything that would have caused it. Started feeling yesterday but is better already today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-28
- 2021-02-04
-
2021-02-11
Dose 2 — Moderna
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-25
-
2021-03-04
Survey response — day 21, dose 2MedDRA: Hospitalisation, Platelet count, Platelet count decreased — Feeling: Fair · Be unable to work, 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: Very low platelet levels, in hospital for three days. Currently at home on prednisoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-04
Report sent to call center — day 21, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-11
- 2021-03-18
- 2021-03-25
-
2021-05-13
Survey response — 3 months, dose 2MedDRA: Platelet count decreased, Self-medication — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Low platelets, ITP. Currently on Prednisone started end of February with 100 mg/day, currently at 30 mg/day. Issues are mostly prednisone side effects.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-13
Report sent to call center — 3 months, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-12
-
2021-11-11
Dose 3 — Moderna
-
2021-11-11
Survey response — day 0, dose 3MedDRA: Pre-existing disease — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: Note: The symptoms are not new and not related to the Covid booster jab received todayMedDRA releases: 2024-11 · check-in free text available
-
2021-11-12
Survey response — days 1–6 daily, dose 3MedDRA: Unevaluable event — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: Nothing new or specific to the booster jabMedDRA releases: 2024-11 · check-in free text available
- 2021-11-13
-
2021-11-14
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
-
2021-11-15
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
-
2021-11-16
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
- 2021-11-17
- 2021-11-19
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-04 | Unsuccessful | |
| 2021-05-13 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): The muscle pain is around the inside of the left elbow. Got the jab in the left arm. Dont remember doing anything that would have caused it. Started feeling yesterday but is better already today.
Release 5 — day 21, dose 2
Symptoms: Very low platelet levels, in hospital for three days. Currently at home on prednisone
Release 8 — 3 months, dose 2
Symptoms: Low platelets, ITP. Currently on Prednisone started end of February with 100 mg/day, currently at 30 mg/day. Issues are mostly prednisone side effects.
Release 10 — day 0, dose 3
Systemic reaction (other): Note: The symptoms are not new and not related to the Covid booster jab received today
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Nothing new or specific to the booster jab
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 | Hospitalisation | ✓ | · | ✓ |
| SD | Platelet count | ○ | ✓ | ○ |
| SD | Platelet count decreased | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release