ZPC-18234-47619
5 vaccinations
9 coded responses
64 check-ins
9 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 277 / NC
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-05
Registered in v-safe
-
2021-03-05
Dose 1 — Moderna
-
2021-03-05
Survey response — day 0, dose 1MedDRA: Feeling hot, Hyperhidrosis — Feeling: Good · Site: PainFree text: I felt warm with a little back sweating for a few minutes about two hours after the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fever · Chills, Headache, Fatigue or tirednessAdult check-in
- 2021-03-07
-
2021-03-08
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
- 2021-03-10
-
2021-03-11
Survey response — days 1–6 daily, dose 1MedDRA: Paranasal sinus discomfort — Feeling: GoodFree text: Very mild sinus pressure.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
- 2021-03-19
- 2021-03-26
-
2021-04-01
Dose 2 — Moderna
-
2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Feeling hot — Feeling: Good · Site: Pain · Chills, Fatigue or tirednessFree text: Warmer than usual for about 5 hours during the night, but no sweating.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-03
- 2021-04-04
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Epistaxis — Feeling: GoodFree text: Very small amount of blood in nose. Could be from a few hard sneezes. Pollen levels have increased.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-24
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-07-01
- 2021-09-30
-
2021-11-20
Dose 3 — Moderna
- 2021-11-21
- 2021-11-22
- 2021-11-23
- 2021-11-24
- 2021-11-25
- 2021-11-26
- 2021-11-27
- 2021-12-04
-
2021-12-11
Survey response — day 21, dose 3MedDRA: Livedo reticularis, Pruritus, Rash macular, Self-medication, Skin warm, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Light hives come and go. Light blotches and streaks. Started around 12/4. On neck, back, arms, hands. Skin feels warm, but symptoms go away. Only slight itch. No particular rhythm to timing or appearance. Using hydrocortisone, Benadryl, prednisone.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-11
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-14
-
2021-12-14
Call successfulParticipant prefers to complete VAERS report online
- 2021-12-18
- 2021-12-25
- 2022-01-01
- 2022-02-19
-
2022-05-20
Dose 4 — Moderna
- 2022-05-20
- 2022-05-21
- 2022-05-22
-
2022-05-23
Survey response — days 1–6 daily, dose 4MedDRA: Hypersomnia — Feeling: GoodFree text: Not tired, but more sleep over the last few days.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-24
Survey response — days 1–6 daily, dose 4MedDRA: Somnolence — Feeling: GoodFree text: Drowsy, but not tired.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-25
- 2022-05-26
- 2022-05-27
- 2022-06-04
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-01
- 2022-08-19
-
2022-10-25
Dose 5 — ModernaCo-administered: Flu
-
2022-10-26
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-10-27
- 2022-10-28
- 2022-10-30
- 2022-10-31
- 2022-11-01
- 2022-11-08
- 2022-11-15
-
2022-11-22
Survey response — day 28, dose 5MedDRA: Injection site pruritus — Feeling: GoodFree text: Minor itching in vaccination area.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-29
- 2022-12-06
- 2023-01-24
- 2023-04-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-20 | Moderna | No |
| 4 | 2022-05-20 | Moderna | No |
| 5 | 2022-10-25 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-11 | Successful 2021-12-14 |
Participant prefers to complete VAERS report online |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): I felt warm with a little back sweating for a few minutes about two hours after the shot.
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Very mild sinus pressure.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Warmer than usual for about 5 hours during the night, but no sweating.
Systemic reaction (other): Very small amount of blood in nose. Could be from a few hard sneezes. Pollen levels have increased.
Release 10 — day 21, dose 3
Symptoms: Light hives come and go. Light blotches and streaks. Started around 12/4. On neck, back, arms, hands. Skin feels warm, but symptoms go away. Only slight itch. No particular rhythm to timing or appearance. Using hydrocortisone, Benadryl, prednisone. cut off by CDC
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Not tired, but more sleep over the last few days.
Systemic reaction (other): Drowsy, but not tired.
Release 12 — day 28, dose 5
Symptoms: Minor itching in vaccination area.
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 | Injection site pruritus | · | · | ✓ |
| SD | Livedo reticularis | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash macular | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Skin warm | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Epistaxis | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Hypersomnia | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Paranasal sinus discomfort | ✓ | ✓ | ✓ |
| SRO | Somnolence | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release