ZRC-27014-11646
3 vaccinations
5 coded responses
33 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 535 / WI
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-18
Registered in v-safe
-
2021-02-18
Dose 1 — Moderna
- 2021-02-18
-
2021-02-19
Survey response — days 1–6 daily, dose 1MedDRA: Muscular weakness — Feeling: Good · Site: Pain · Muscle or body achesFree text: Hand feel weak. Dropped coffee this morning and glass of milk this afternoonMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
-
2021-02-25
Survey response — day 7, dose 1MedDRA: Hypoaesthesia, Pre-existing disease — Feeling: Good · Site: Pain, Swelling · Joint painsFree text: I had some knee pain from some arthritis before I got vaccine. This week Ive notice my toes on that side are a little numb at nighttime. Might just be from knee problemMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-11
-
2021-03-18
Dose 2 — Moderna
- 2021-03-18
-
2021-03-19
Survey response — days 1–6 daily, dose 2MedDRA: Chills — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body achesFree text: Chills with no temperature.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
-
2021-06-17
Survey response — 3 months, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: On June 2 I started Ilumya. Not sure how that will affect my immunity to COVID or if I should get a 3rd COVID vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-09-17
-
2021-10-22
Dose 3 — Moderna
- 2021-10-28
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-28
- 2021-12-03
-
2022-04-25
Survey response — 6 months, dose 3MedDRA: Back disorder, Neuralgia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Nerve pain in leg caused from lower back issuesMedDRA releases: 2024-11 · check-in free text available
-
2022-04-25
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 · 1 call case(s)
- 2022-04-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-18 | Moderna | |
| 2 | 2021-03-18 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-25 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Hand feel weak. Dropped coffee this morning and glass of milk this afternoon
Release 4 — day 7, dose 1
Systemic reaction (other): I had some knee pain from some arthritis before I got vaccine. This week Ive notice my toes on that side are a little numb at nighttime. Might just be from knee problem
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Chills with no temperature.
Release 9 — 3 months, dose 2
Symptoms: On June 2 I started Ilumya. Not sure how that will affect my immunity to COVID or if I should get a 3rd COVID vaccine.
Release 11 — 6 months, dose 3
Symptoms: Nerve pain in leg caused from lower back issues
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 |
|---|---|---|---|---|
| SD | Back disorder | · | · | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Muscular weakness | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release