ZQZ-27338-70978
6 vaccinations
11 coded responses
42 check-ins
8 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 954 / CA
- Registered
- 2021-08-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Dose 1 — Moderna
-
2021-02-22
Dose 2 — Moderna
-
2021-08-27
Dose 3 — Moderna
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2021-08-28
Registered in v-safe
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2021-08-28
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain, Injection site swelling — Feeling: Good · Site: Pain, SwellingFree text: Other than slight ache and swelling at injection site, there has been no reaction so far. It has been 23 hours since the third dose.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-29
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain — Feeling: GoodFree text: Other than slight ache yesterday at injection site, there have been no side effects so far to third dose.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-30
Survey response — days 1–6 daily, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I often feel tired, but have felt more tired than usual for the last 18 hours. Not weak, just tired.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-08-31
- 2021-09-01
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2021-09-02
Survey response — days 1–6 daily, dose 3MedDRA: Fatigue — Feeling: Good · Fatigue or tirednessFree text: The tiredness likely is due to lack of sleep, not to the vaccine.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-09-03
- 2021-09-10
- 2021-09-17
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2021-09-24
Survey response — day 28, dose 3MedDRA: Dizziness, Fatigue — Feeling: FairFree text: Dizzy and unusually tired last night and this morning. 12mg meclizine this morning controlled the dizziness. No reason to associate these symptoms with vaccinations (had senior flu vaccination on 9/10; 2 weeks after 3rd dose of Moderna).MedDRA releases: 2024-11 · check-in free text available
- 2021-10-01
- 2021-10-08
- 2021-11-26
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2022-02-25
Survey response — 6 months, dose 3MedDRA: Pre-existing disease, Unevaluable event — Feeling: Good · 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: Symptoms: They were not related to covid, but to pre-existing conditions whose treatments were delayed by my reluctance to be hospitalized before being vaccinated and boosted against covid. · Healthcare visit (other): None of these were related to having covid, but some of them probably would not have occurred had I not delayed treatment out of fear of contracting covid while hospitalizedMedDRA releases: 2024-11 · check-in free text available
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2022-02-25
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-03-01
-
2022-03-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-03-31
Dose 4 — Moderna
- 2022-04-01
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2022-04-02
Survey response — days 1–6 daily, dose 4MedDRA: Arthralgia — Feeling: Good · Site: PainFree text: No noticeable reaction at all, other than mild ache at vaccination site on shoulderMedDRA releases: 2024-11 · check-in free text available
- 2022-04-03
- 2022-04-04
- 2022-04-05
- 2022-04-06
- 2022-04-07
- 2022-04-14
- 2022-04-21
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-06-30
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2022-09-29
Survey response — 6 months, dose 4MedDRA: Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Diagnosis of myelofibrosis. Unrelated to vaccination. Probably began before Sars-CoV-2 appeared.MedDRA releases: 2024-11 · check-in free text available
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2022-09-29
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-09-30
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-10-14
Dose 5 — Moderna
- 2023-03-31
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2023-04-19
Dose 6 — Moderna
- 2023-04-19
- 2023-04-20
- 2023-04-21
- 2023-04-22
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2023-04-23
Survey response — days 1–6 daily, dose 6MedDRA: Pre-existing disease — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
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2023-04-24
Survey response — days 1–6 daily, dose 6MedDRA: Unevaluable event — Feeling: GoodMedDRA releases: 2024-11
- 2023-04-25
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2023-04-26
Survey response — day 7, dose 6MedDRA: Fatigue, Pre-existing disease, White blood cell count increased — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-05-03
- 2023-05-10
- 2023-05-17
- 2023-05-24
- 2023-05-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | No |
| 2 | 2021-02-22 | Moderna | No |
| 3 | 2021-08-27 | Moderna | No |
| 4 | 2022-03-31 | Moderna | No |
| 5 | 2022-10-14 | Moderna | No |
| 6 | 2023-04-19 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-25 | Successful 2022-03-01 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-09-29 | Successful 2022-09-30 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Other than slight ache and swelling at injection site, there has been no reaction so far. It has been 23 hours since the third dose.
Systemic reaction (other): Other than slight ache yesterday at injection site, there have been no side effects so far to third dose.
Systemic reaction (other): I often feel tired, but have felt more tired than usual for the last 18 hours. Not weak, just tired.
Systemic reaction (other): The tiredness likely is due to lack of sleep, not to the vaccine.
Release 9 — day 28, dose 3
Symptoms: Dizzy and unusually tired last night and this morning. 12mg meclizine this morning controlled the dizziness. No reason to associate these symptoms with vaccinations (had senior flu vaccination on 9/10; 2 weeks after 3rd dose of Moderna).
Release 11 — 6 months, dose 3
Symptoms: They were not related to covid, but to pre-existing conditions whose treatments were delayed by my reluctance to be hospitalized before being vaccinated and boosted against covid.
Healthcare visit (other): None of these were related to having covid, but some of them probably would not have occurred had I not delayed treatment out of fear of contracting covid while hospitalized
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): No noticeable reaction at all, other than mild ache at vaccination site on shoulder
Release 12 — 6 months, dose 4
Symptoms: Diagnosis of myelofibrosis. Unrelated to vaccination. Probably began before Sars-CoV-2 appeared.
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 | Unevaluable event | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Condition aggravated | ✓ | · | ✓ |
| SRO | Fatigue | ✓ | · | ✓ |
| SRO | Injection site pain | ✓ | · | ✓ |
| SRO | Injection site swelling | ✓ | · | ✓ |
| SRO | Pre-existing disease | ✓ | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
| SRO | White blood cell count increased | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release