ZS6-54474-29211
6 vaccinations
7 coded responses
66 check-ins
7 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 980 / WA
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Dose 1 — Moderna
-
2021-01-26
Registered in v-safe
-
2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Eye disorder, Nausea — Feeling: Good · Site: PainFree text: Day after shot (1/21/21 woke up with left eye vision issue. Went away within 15 minutes. Day 2post shot 1/22/21 had slight nausea and it resolved in a few hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
- 2021-02-03
-
2021-02-10
Survey response — day 21, dose 1MedDRA: Deafness unilateral, Drainage, Head discomfort, Increased upper airway secretion, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Not clear if related - some hearing loss in my one good ear that included head fullness and back of throat drainage. This Started on Friday and hearing & became worst on Sunday. It started to improve slightly on a Monday and Dr. on Tuesday. · Healthcare visit (other): In office Dr. visit with hearing test.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-10
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-17
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
-
2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Eye disorder, Medical counselling, Nausea, Tunnel vision — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Nausea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): As with my first dose, I had a left eye issue after waking up that lasted about 15 minutes. Its like looking through a circle with symmetrical radiating cones in the circle, · Healthcare visit (other): Portal question about managing the nausea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-25
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Deafness — Feeling: FairFree text: I feel residual from yesterday day later effects. Plus some hearing loss.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
-
2021-03-24
Survey response — day 28, dose 2MedDRA: Pre-existing disease, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Tinnitus continuing in left ear. It was identified as possible side effect from 1st (1/20/21) &!again after 2nd dose (2/24/21). I have menieres in right ear that is in burn out. Soooo I only have my left ear as a good ear!! Ive been onMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-24
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-31
Survey response — day 35, dose 2MedDRA: Pre-existing disease, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Continued problems with tinnitus in Left ear. I have almost no hearing in right ear due to menieres, so left ear problem is a big problem!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-31
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-07
- 2021-05-26
- 2021-06-10
- 2021-06-10
- 2021-06-10
- 2021-06-10
-
2021-08-19
Dose 3 — Moderna
- 2021-08-19
-
2021-08-20
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
- 2021-08-21
- 2021-08-22
- 2021-08-23
- 2021-08-24
- 2021-08-25
-
2021-08-26
Survey response — day 7, dose 3MedDRA: Unevaluable event — Feeling: Good · Joint painsFree text: Left elbowMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-09-02
- 2021-09-09
- 2021-09-16
- 2021-09-23
- 2021-09-30
- 2021-11-18
-
2022-01-27
Dose 4 — Moderna
- 2022-02-17
- 2022-02-17
- 2022-02-24
- 2022-03-03
- 2022-03-10
- 2022-04-28
-
2022-05-31
Dose 5 — Moderna
-
2022-06-01
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-06-02
-
2022-06-03
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Redness · Fatigue or tirednessAdult check-in
-
2022-06-04
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2022-06-05
- 2022-06-06
- 2022-06-07
- 2022-06-14
- 2022-06-21
- 2022-06-28
- 2022-07-05
- 2022-07-12
- 2022-08-30
-
2022-09-14
Dose 6 — Moderna
- 2022-09-14
- 2022-09-16
- 2022-09-17
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-28
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-12-14
- 2023-03-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-08-19 | Moderna | No |
| 4 | 2022-01-27 | Moderna | No |
| 5 | 2022-05-31 | Moderna | No |
| 6 | 2022-09-14 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-10 | Unsuccessful | |
| 2021-02-25 | Unsuccessful | |
| 2021-03-24 | Unsuccessful | |
| 2021-03-31 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Day after shot (1/21/21 woke up with left eye vision issue. Went away within 15 minutes. Day 2post shot 1/22/21 had slight nausea and it resolved in a few hours.
Release 4 — day 21, dose 1
Symptoms: Not clear if related - some hearing loss in my one good ear that included head fullness and back of throat drainage. This Started on Friday and hearing & became worst on Sunday. It started to improve slightly on a Monday and Dr. on Tuesday.
Healthcare visit (other): In office Dr. visit with hearing test.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): As with my first dose, I had a left eye issue after waking up that lasted about 15 minutes. Its like looking through a circle with symmetrical radiating cones in the circle,
Healthcare visit (other): Portal question about managing the nausea.
Systemic reaction (other): I feel residual from yesterday day later effects. Plus some hearing loss.
Release 6 — day 28, dose 2
Symptoms: Tinnitus continuing in left ear. It was identified as possible side effect from 1st (1/20/21) &!again after 2nd dose (2/24/21). I have menieres in right ear that is in burn out. Soooo I only have my left ear as a good ear!! Ive been on
Release 6 — day 35, dose 2
Symptoms: Continued problems with tinnitus in Left ear. I have almost no hearing in right ear due to menieres, so left ear problem is a big problem!
Release 9 — day 7, dose 3
Systemic reaction (other): Left elbow
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 | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Nausea | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Deafness unilateral | · | · | ✓ |
| SD | Drainage | ✓ | ✓ | ○ |
| SD | Head discomfort | ✓ | ✓ | ✓ |
| SD | Increased upper airway secretion | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Tinnitus | ✓ | ✓ | ✓ |
| SRO | Deafness | ✓ | ✓ | ✓ |
| SRO | Eye disorder | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Tunnel vision | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release