ZSZ-18217-53621
2 vaccinations
3 coded responses
9 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 970 / OR
- Registered
- 2021-10-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
3G4-14855-60998
Adult relative or friend · Male · 2021-10-31
YNL-28292-35350
Child or adolescent in my care · Female · 2021-10-31
Timeline
-
2021-03-11
Dose 1 — Janssen/Johnson & Johnson
-
2021-10-29
Dose 2 — Moderna
-
2021-10-31
Registered in v-safe
-
2021-10-31
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: DizzyMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
- 2021-11-04
- 2021-11-12
-
2021-11-26
Survey response — day 28, dose 2MedDRA: Cough, Gastrointestinal disorder, Pyrexia — Feeling: Poor · Be unable to work or attend schoolFree text: Cough, fever, stomach issuesMedDRA releases: 2024-11 · check-in free text available
- 2022-01-28
- 2022-04-29
-
2022-10-31
Survey response — 12 months, dose 2MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, 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: I had CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-10-31
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-11-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Janssen/Johnson & Johnson | No |
| 2 | 2021-10-29 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-31 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): Dizzy
Release 10 — day 28, dose 2
Symptoms: Cough, fever, stomach issues
Release 12 — 12 months, dose 2
Symptoms: I had Covid
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 | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release