ZQE-31202-39223
4 vaccinations
6 coded responses
43 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 983 / WA
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-26
Dose 1 — Moderna
-
2021-02-27
Registered in v-safe
- 2021-02-27
- 2021-02-28
-
2021-03-01
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Self-medication — Feeling: Good · Joint painsFree text: Joint pain in both knees came suddenly in the night. One extra strength Tylenol and the joint pain disappeared within an hour.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
-
2021-03-26
Dose 2 — Moderna
- 2021-03-26
-
2021-03-27
Survey response — days 1–6 daily, dose 2MedDRA: Self-medication — Feeling: Fair · Site: Pain · Headache, Joint painsFree text: I took one extra strength (500 mg) Tylenol at 5 am, rubbed 50mg hemp oil extract on injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-06-25
- 2021-09-24
-
2021-10-26
Dose 3 — Moderna
- 2021-10-26
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Immunisation reaction, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I have an auto immune disease, Sjogrens. I do not take immuno suppressents. I'm thinking that may account for my strong reaction to the booster.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-09
- 2021-11-16
-
2021-11-23
Survey response — day 28, dose 3MedDRA: Cardiac ablation, Cardiac operation, Halo vision — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: I had cardiac surgery, Afib alation, (TS approach) On 11/17. I am taking 400 mg amiodorone for a month, then 200 mg for a month. I had some visual haloing 4 days post surgery, now gone. Reported symptoms are not Covid related, Im sure.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-23
Report sent to call center — day 28, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
-
2021-11-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2021-11-30
- 2021-12-07
- 2022-01-25
-
2022-03-31
Dose 4 — Moderna
-
2022-04-26
Survey response — 6 months, dose 3MedDRA: Cataract operation, Exposure to SARS-CoV-2, Malignant melanoma, Office visit, Squamous cell carcinoma, Wound — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Squamous cell carcinoma on shin triggered by wound trauma. I don't think it was related at all to the Covid vaccine. I also had cataract surgery which was successful. Recently, I had close exposure to Covid. So far daily tests have been negative · Healthcare visit (other): Dermatologist that treats me for melanoma. Ongoing since 2007.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-26
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
-
2022-05-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-14
Survey response — day 42, dose 4MedDRA: Cancer surgery, Surgery, Wound — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Surgical excision of invasive squamous cell carcinoma. Ongoing, unrelated to Covid. Although the cancer grew quickly from a trauma wound this time which I believe is unusual. · Healthcare visit (other): Outpatient Surgery in hospitalMedDRA releases: 2024-11 · check-in free text available
-
2022-05-14
Report sent to call center — day 42, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-05-16
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-06-30
- 2022-09-30
- 2023-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-26 | Moderna | |
| 2 | 2021-03-26 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-03-31 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-23 | Successful 2021-11-24 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-04-26 | Successful 2022-05-03 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-05-14 | Successful 2022-05-16 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Joint pain in both knees came suddenly in the night. One extra strength Tylenol and the joint pain disappeared within an hour.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): I took one extra strength (500 mg) Tylenol at 5 am, rubbed 50mg hemp oil extract on injection site.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I have an auto immune disease, Sjogrens. I do not take immuno suppressents. I'm thinking that may account for my strong reaction to the booster.
Release 10 — day 28, dose 3
Symptoms: I had cardiac surgery, Afib alation, (TS approach) On 11/17. I am taking 400 mg amiodorone for a month, then 200 mg for a month. I had some visual haloing 4 days post surgery, now gone. Reported symptoms are not Covid related, Im sure.
Release 11 — 6 months, dose 3
Symptoms: Squamous cell carcinoma on shin triggered by wound trauma. I don't think it was related at all to the Covid vaccine. I also had cataract surgery which was successful. Recently, I had close exposure to Covid. So far daily tests have been negative cut off by CDC
Healthcare visit (other): Dermatologist that treats me for melanoma. Ongoing since 2007.
Release 11 — day 42, dose 4
Symptoms: Surgical excision of invasive squamous cell carcinoma. Ongoing, unrelated to Covid. Although the cancer grew quickly from a trauma wound this time which I believe is unusual.
Healthcare visit (other): Outpatient Surgery in hospital
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 | Malignant melanoma | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Surgery | · | · | ✓ |
| SD | Cancer surgery | · | · | ✓ |
| SD | Cardiac ablation | · | · | ✓ |
| SD | Cardiac operation | · | · | ✓ |
| SD | Cataract operation | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Halo vision | · | · | ✓ |
| SD | Squamous cell carcinoma | · | · | ✓ |
| SD | Wound | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Immunisation reaction | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release