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ZRJ-99494-32371

2 vaccinations 5 coded responses 15 check-ins 5 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
785 / TX
Registered
2021-02-17
Relationship
Self
Race
Other
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-01-22
    Dose 1 — Moderna
  2. 2021-02-17
    Registered in v-safe
  3. 2021-02-17
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  4. 2021-02-19
    Dose 2 — Moderna
  5. 2021-02-19
    Health check-in — day 0, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  6. 2021-02-20
    Survey response — days 1–6 daily, dose 2
    MedDRA: Sluggishness — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Feel very sluggish.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Chills
    Adult check-in
  8. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-02-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-02-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Abdominal pain · Be unable to do your normal daily activities
    Free text: Monday I had a severe case of acid reflux and today again but not as severe.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-26
    Survey response — day 7, dose 2
    MedDRA: Abdominal pain upper, Chest pain, Constipation, Gastrooesophageal reflux disease, Medical counselling — Feeling: Fair · Fatigue or tiredness, Abdominal pain · Get care from a doctor or other healthcare professional
    Free text: Systemic reaction (other): Besides acid reflux, Ive been constipated for days. · Healthcare visit (other): I called my doctors office for medication for acid reflux when I had sharp chest pain in the stomach.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-26
    Report sent to call center — day 7, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-03-05
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-03-15
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-03-22
    Survey response — day 28, dose 2
    MedDRA: Abdominal pain upper, Asthenia — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Low energy and stomach cramps.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-28
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-04-04
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-05-23
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-09-08
  20. 2021-09-13
  21. 2021-09-13
  22. 2022-02-19
    Survey response — 12 months, dose 2
    MedDRA: Office visit, Pulmonary function test abnormal, Respiratory disorder — Feeling: Poor · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Saw my lung specialist for breathing problems. A lung test came back not acceptable so I just had another test done yesterday to check for blood clots. Don't have results yet. · Healthcare visit (other): Doctors visit
    MedDRA releases: 2024-11 · check-in free text available
  23. 2022-02-19
    Report sent to call center — 12 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  24. 2022-02-22
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-01-22Moderna
22021-02-19Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-02-26 Successful Participant prefers to complete VAERS report online
2022-02-19 Successful
2022-02-22
Participant prefers to complete VAERS report online

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Feel very sluggish.

2021-02-24

Systemic reaction (other): Monday I had a severe case of acid reflux and today again but not as severe.

Release 4 — day 7, dose 2

2021-02-26

Systemic reaction (other): Besides acid reflux, Ive been constipated for days.
Healthcare visit (other): I called my doctors office for medication for acid reflux when I had sharp chest pain in the stomach.

Release 6 — day 28, dose 2

2021-03-22

Symptoms: Low energy and stomach cramps.

Release 11 — 12 months, dose 2

2022-02-19

Symptoms: Saw my lung specialist for breathing problems. A lung test came back not acceptable so I just had another test done yesterday to check for blood clots. Don't have results yet.
Healthcare visit (other): Doctors visit

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
HCVOAbdominal pain upper ✓ ✓ ✓
HCVOChest pain ✓ ✓ ✓
HCVOMedical counselling ✓ ✓ ✓
HCVOOffice visit · · ✓
SDAbdominal pain upper ✓ ✓ ✓
SDAsthenia ✓ ✓ ✓
SDOffice visit · · ✓
SDPulmonary function test abnormal · · ✓
SDRespiratory disorder · · ✓
SROConstipation ✓ ✓ ✓
SROGastrooesophageal reflux disease ✓ ✓ ✓
SROSluggishness ✓ ✓ ✓

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