ZSV-84151-22032
5 vaccinations
8 coded responses
37 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 077 / NJ
- Registered
- 2021-01-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Registered in v-safe
-
2021-01-19
Dose 1 — Moderna
- 2021-01-19
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-02-02
- 2021-02-09
-
2021-02-16
Dose 2 — Moderna
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-17
-
2021-11-17
Dose 3 — Moderna
- 2022-02-16
- 2022-05-18
-
2022-05-19
Dose 4 — Moderna
- 2022-06-04
- 2022-06-09
- 2022-06-16
-
2022-06-23
Survey response — day 35, dose 4MedDRA: Chest discomfort, Chills, Cough, Pain, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Chills, total body aches, coughing, chest tightness Tested positive for COVID with a Flowflex COVID-19 Antigen Home TestMedDRA releases: 2024-11 · check-in free text available
-
2022-06-23
Report sent to call center — day 35, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-06-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-06-30
-
2022-08-18
Survey response — 3 months, dose 4MedDRA: Cough, Dysphonia, Medical counselling, Quarantine, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activitiesFree text: I tested positive for COVID-19 the end of June. My symptoms were chest congestion, runny nose, cough. Contacted my MD he told me to quarantine for 5 day; then I could go out with a mask for 5 days. At present I still have a "hoarseness" to my voiceMedDRA releases: 2024-11 · check-in free text available
-
2022-10-11
Dose 5 — ModernaCo-administered: Flu
- 2022-10-12
-
2022-10-13
Survey response — days 1–6 daily, dose 5MedDRA: Injection site pain — Feeling: GoodFree text: Soreness at the booster site, no swelling or rednessMedDRA releases: 2024-11 · check-in free text available
-
2022-10-14
Survey response — days 1–6 daily, dose 5MedDRA: Injection site pain — Feeling: GoodFree text: Soreness at the injection siteMedDRA releases: 2024-11 · check-in free text available
-
2022-10-15
Survey response — days 1–6 daily, dose 5MedDRA: Injection site pain — Feeling: GoodFree text: Soreness at the site of the booster has lessenedMedDRA releases: 2024-11 · check-in free text available
-
2022-10-16
Survey response — days 1–6 daily, dose 5MedDRA: Injection site pain — Feeling: GoodFree text: Soreness at booster site is diminishingMedDRA releases: 2024-11 · check-in free text available
-
2022-10-17
Survey response — days 1–6 daily, dose 5MedDRA: Injection site pain — Feeling: GoodFree text: Soreness at booster site is diminishingMedDRA releases: 2024-11 · check-in free text available
- 2022-10-18
- 2022-10-25
- 2022-11-01
- 2022-11-08
- 2022-11-15
- 2022-11-22
- 2023-01-10
-
2023-04-11
Survey response — 6 months, dose 5MedDRA: Cough, Fatigue, Rhinorrhoea — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-11-17 | Moderna | No |
| 4 | 2022-05-19 | Moderna | No |
| 5 | 2022-10-11 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-23 | Successful 2022-06-24 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — day 35, dose 4
Symptoms: Chills, total body aches, coughing, chest tightness Tested positive for COVID with a Flowflex COVID-19 Antigen Home Test
Release 12 — 3 months, dose 4
Symptoms: I tested positive for COVID-19 the end of June. My symptoms were chest congestion, runny nose, cough. Contacted my MD he told me to quarantine for 5 day; then I could go out with a mask for 5 days. At present I still have a "hoarseness" to my voice cut off by CDC
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Soreness at the booster site, no swelling or redness
Systemic reaction (other): Soreness at the injection site
Systemic reaction (other): Soreness at the site of the booster has lessened
Systemic reaction (other): Soreness at booster site is diminishing
Systemic reaction (other): Soreness at booster site is diminishing
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 | Chest discomfort | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dysphonia | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Medical counselling | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Quarantine | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release