ZQA-75053-05405
5 vaccinations
17 coded responses
48 check-ins
17 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 010 / MA
- Registered
- 2021-03-01
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-03-01
Registered in v-safe
-
2021-03-02
Dose 1 — Moderna
- 2021-03-02
-
2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Tinnitus — Feeling: Good · Site: PainFree text: Mild Tinnitus last nightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
-
2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Diarrhoea — Feeling: Good · NauseaFree text: Loose stoolMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
-
2021-03-08
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal discomfort — Feeling: GoodFree text: Abdominal irritationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
-
2021-03-31
Dose 2 — Moderna
-
2021-03-31
Survey response — day 0, dose 2MedDRA: Dizziness, Feeling jittery — Feeling: FairFree text: Jittery a little lightheadedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Fatigue was intense, but short lived.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-05
-
2021-04-07
Survey response — day 7, dose 2MedDRA: Rhinorrhoea — Feeling: Good · NauseaFree text: Runny nose.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
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2021-04-21
Survey response — day 21, dose 2MedDRA: Arthralgia, Back pain, Pain, SARS-CoV-2 test — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Mild aches in elbows, and later in upper back. · Healthcare visit (other): Went for a Covid testMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-21
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-28
Survey response — day 28, dose 2MedDRA: Diarrhoea, Self-medication — Feeling: GoodFree text: Episode of diarrhea controlled by 2 pepto tablets.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-05
- 2021-05-12
- 2021-06-30
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2021-09-29
Survey response — 6 months, dose 2MedDRA: Ear infection — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Mini ear infection.MedDRA releases: 2024-11 · check-in free text available
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2021-09-29
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-10-01
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2021-10-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2021-10-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-11-14
Dose 3 — Moderna
- 2022-03-31
-
2022-04-14
Dose 4 — Moderna
-
2022-04-20
Survey response — days 1–6 daily, dose 4MedDRA: Nasal congestion — Feeling: Fair · HeadacheFree text: Mild stuffy noseMedDRA releases: 2024-11 · check-in free text available
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2022-04-21
Survey response — day 7, dose 4MedDRA: Diarrhoea — Feeling: FairFree text: Loose bowelsMedDRA releases: 2024-11 · check-in free text available
- 2022-04-28
-
2022-05-05
Survey response — day 21, dose 4MedDRA: Diarrhoea, Irritable bowel syndrome — Feeling: GoodFree text: Irritated bowels. Brief episode of diarrhea.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-12
- 2022-05-19
- 2022-05-26
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2022-07-14
Survey response — 3 months, dose 4MedDRA: Rhinorrhoea — Feeling: GoodFree text: Occasional Runny noseMedDRA releases: 2024-11 · check-in free text available
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2022-09-22
Dose 5 — Moderna
- 2022-09-22
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2022-09-23
Survey response — days 1–6 daily, dose 5MedDRA: Rhinorrhoea — Feeling: Good · Site: PainFree text: Mild runny noseMedDRA releases: 2024-11 · check-in free text available
-
2022-09-24
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Headache, Rash, not including the immediate area around the injection siteAdult check-in
- 2022-09-25
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2022-09-26
Survey response — days 1–6 daily, dose 5MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
- 2022-09-27
- 2022-09-28
- 2022-09-29
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2022-10-06
Survey response — day 14, dose 5MedDRA: Irritable bowel syndrome — Feeling: FairFree text: Irritated bowelsMedDRA releases: 2024-11 · check-in free text available
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2022-10-14
Survey response — day 21, dose 5MedDRA: Oropharyngeal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
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2022-10-14
Report sent to call center — day 21, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-10-17
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-12-22
- 2023-03-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-31 | Moderna | |
| 3 | 2021-11-14 | Moderna | No |
| 4 | 2022-04-14 | Moderna | No |
| 5 | 2022-09-22 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-21 | Successful 2021-10-01 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2021-09-29 | Successful 2021-10-01 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-10-14 | Successful 2022-10-17 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Mild Tinnitus last night
Systemic reaction (other): Loose stool
Systemic reaction (other): Abdominal irritation
Release 6 — day 0, dose 2
Systemic reaction (other): Jittery a little lightheaded
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Fatigue was intense, but short lived.
Release 7 — day 7, dose 2
Systemic reaction (other): Runny nose.
Release 7 — day 21, dose 2
Symptoms: Mild aches in elbows, and later in upper back.
Healthcare visit (other): Went for a Covid test
Release 8 — day 28, dose 2
Symptoms: Episode of diarrhea controlled by 2 pepto tablets.
Release 9 — 6 months, dose 2
Symptoms: Mini ear infection.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Mild stuffy nose
Release 11 — day 7, dose 4
Systemic reaction (other): Loose bowels
Release 11 — day 21, dose 4
Symptoms: Irritated bowels. Brief episode of diarrhea.
Release 12 — 3 months, dose 4
Symptoms: Occasional Runny nose
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Mild runny nose
Systemic reaction (other): Runny nose
Release 12 — day 14, dose 5
Symptoms: Irritated bowels
Release 12 — day 21, dose 5
Symptoms: Sore throat
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 | SARS-CoV-2 test | ✓ | ✓ | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Irritable bowel syndrome | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ○ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling jittery | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release