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ZR5-31957-24600

5 vaccinations 4 coded responses 42 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
662 / KS
Registered
2021-01-06
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-06
    Registered in v-safe
  2. 2021-01-06
    Dose 1 — Moderna
  3. 2021-01-06
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-01-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Poor · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  8. 2021-01-12
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to work · Be unable to do your normal daily activities
    1 call case(s)
  9. 2021-01-13
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-20
    Survey response — day 14, dose 1
    MedDRA: Injection site erythema, Injection site pruritus, Injection site reaction, Injection site swelling, Urticaria — Feeling: Good
    Free text: One week and one day later my injection site was itchy, a bit red and raised like a welt. No big deal but surprising.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-01-27
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-03
    Dose 2 — Moderna
  13. 2021-02-03
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  14. 2021-02-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Redness, Swelling · Chills
    Free text: Slightly elevated temperature when preparing for bed yesterday (about 15 hours after injection) 99.8 last night, then 98.6 this morning
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work
    Adult check-in
  16. 2021-02-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-02-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-10
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-02-17
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-02-24
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-03
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-10
    Survey response — day 35, dose 2
    MedDRA: Arthralgia — Feeling: Good
    Free text: Shoulder pain in left shoulder. My first injection was in the left shoulder, pain began around that time and seems to be worsening. I dont think it is related to the vaccination.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-03-17
    Survey response — day 42, dose 2
    MedDRA: Arthralgia, Fatigue — Feeling: Fair
    Free text: Fatigue, shoulder pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-05-05
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-08-04
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-11-03
    Dose 3 — Moderna
  28. 2022-02-03
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2022-04-11
    Dose 4 — Moderna
  30. 2022-04-26
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  31. 2022-05-02
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  32. 2022-05-09
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  33. 2022-05-16
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  34. 2022-05-23
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  35. 2022-07-11
    Health check-in — 3 months, dose 4
    Feeling: Fair
    Adult check-in
  36. 2022-09-30
    Dose 5 — Moderna
  37. 2022-10-02
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · None
    Adult check-in
  38. 2022-10-03
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · None
    Adult check-in
  39. 2022-10-04
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · None
    Adult check-in
  40. 2022-10-05
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · None
    Adult check-in
  41. 2022-10-06
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · None
    Adult check-in
  42. 2022-10-07
    Health check-in — day 7, dose 5
    Feeling: Good · None
    Adult check-in
  43. 2022-10-14
    Health check-in — day 14, dose 5
    Feeling: Good
    Adult check-in
  44. 2022-10-21
    Health check-in — day 21, dose 5
    Feeling: Good
    Adult check-in
  45. 2022-10-28
    Health check-in — day 28, dose 5
    Feeling: Good
    Adult check-in
  46. 2022-11-04
    Health check-in — day 35, dose 5
    Feeling: Good
    Adult check-in
  47. 2022-11-11
    Health check-in — day 42, dose 5
    Feeling: Good
    Adult check-in
  48. 2022-12-30
    Health check-in — 3 months, dose 5
    Feeling: Good
    Adult check-in
  49. 2023-03-31
    Health check-in — 6 months, dose 5
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-06Moderna
22021-02-03Moderna
32021-11-03Moderna No
42022-04-11Moderna No
52022-09-30Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-01-12 priority 2/3

Free text

Release 2 — day 14, dose 1

2021-01-20

Symptoms: One week and one day later my injection site was itchy, a bit red and raised like a welt. No big deal but surprising.

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Slightly elevated temperature when preparing for bed yesterday (about 15 hours after injection) 99.8 last night, then 98.6 this morning

Release 5 — day 35, dose 2

2021-03-10

Symptoms: Shoulder pain in left shoulder. My first injection was in the left shoulder, pain began around that time and seems to be worsening. I dont think it is related to the vaccination.

Release 5 — day 42, dose 2

2021-03-17

Symptoms: Fatigue, shoulder pain

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site pruritus ✓ ✓ ✓
SDInjection site reaction ✓ ✓ ✓
SDInjection site swelling ✓ ✓ ✓
SDUrticaria ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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