ZPW-23771-49725
1 vaccination
3 coded responses
3 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 577 / SD
- Registered
- 2021-04-11
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-04-01
Dose 1 — Moderna
-
2021-04-11
Registered in v-safe
-
2021-04-11
Survey response — day 7, dose 1MedDRA: Erythema, Mass, Pain — Feeling: Good · Site: RednessFree text: Red, painful lump at gluteal cleft. Appeared yesterday. Unrelated?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-15
Survey response — day 14, dose 1MedDRA: Cyst, Fatigue, Malaise, Pain, Pilonidal disease, Somnolence — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Pilondial cyst. Feel just a general Ill feeling. Very tired. Just want to sleep. All over body aches. · Healthcare visit (other): Care for the cyst. I havent been working as I had an SI fusion 3 weeks ago but if I was working I would have called out with these symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-15
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-26
Survey response — day 21, dose 1MedDRA: Fatigue, Headache, Injection site warmth, Nausea, Pain, Rash, Skin warm — Feeling: Fair · Be unable to do your normal daily activitiesFree text: 1 week post vaccine I developed a red rash on my arm where I received the shot that was a warm to the touch. 2 weeks post vaccine I got sick. Body aches, nauseous, headache, extreme exhaustion. Lasted for 3 days. I do not plan to get the 2nd shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2022-02-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-15 | Unsuccessful |
Free text
Release 7 — day 7, dose 1
Systemic reaction (other): Red, painful lump at gluteal cleft. Appeared yesterday. Unrelated?
Release 7 — day 14, dose 1
Symptoms: Pilondial cyst. Feel just a general Ill feeling. Very tired. Just want to sleep. All over body aches.
Healthcare visit (other): Care for the cyst. I havent been working as I had an SI fusion 3 weeks ago but if I was working I would have called out with these symptoms.
Release 8 — day 21, dose 1
Symptoms: 1 week post vaccine I developed a red rash on my arm where I received the shot that was a warm to the touch. 2 weeks post vaccine I got sick. Body aches, nauseous, headache, extreme exhaustion. Lasted for 3 days. I do not plan to get the 2nd shot. cut off by CDC
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 | Cyst | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pilonidal disease | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Skin warm | ✓ | ✓ | ✓ |
| SD | Somnolence | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Mass | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release