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ZSZ-19502-08953

4 vaccinations 7 coded responses 46 check-ins 6 free-text entries 4 call cases
Sex
Male
Age at first dose
61-65
ZIP prefix
480 / MI
Registered
2021-03-02
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-02
    Registered in v-safe
  2. 2021-03-02
    Dose 1 — Moderna
  3. 2021-03-02
    Health check-in — day 0, dose 1
    Feeling: Good · Headache
    Adult check-in
  4. 2021-03-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-03-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  6. 2021-03-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  7. 2021-03-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-09
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-03-16
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-03-23
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-03-30
    Dose 2 — Moderna
  14. 2021-03-30
    Health check-in — day 0, dose 2
    Feeling: Good · Headache
    Adult check-in
  15. 2021-03-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-04-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  17. 2021-04-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-04-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-04-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-04-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-04-06
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-04-13
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-22
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-27
    Survey response — day 28, dose 2
    MedDRA: Chest pain, Stenosis — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Its due to my lower back and stenosis. Radiating pain up right chest area
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-04-27
    Report sent to call center — day 28, dose 2
    Be unable to work · Get care from a doctor or other healthcare professional
    1 call case(s)
  26. 2021-05-04
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-05-13
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-06-29
    Survey response — 3 months, dose 2
    MedDRA: Nasal congestion, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Severe cold - nasal and chest congestion
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  29. 2021-09-28
    Survey response — 6 months, dose 2
    MedDRA: Cough, Malaise, Medical counselling, Respiratory symptom, SARS-CoV-2 test negative, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms: Possibly had RSV in June. Spoke with my doctor and the symptoms were that of RSV and similar to COVID. Had a negative Covid test. Took approximately 3weeks to clear the cough and upper respiratory. · Healthcare visit (other): Doctor in neighborhood
    MedDRA releases: 2024-11 · check-in free text available
  30. 2021-09-28
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  31. 2021-09-29
  32. 2021-11-01
    Dose 3 — Moderna
  33. 2021-11-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Headache · Be unable to work or attend school
    Adult check-in
  34. 2021-11-04
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Headache · Be unable to work or attend school
    Adult check-in
  35. 2021-11-05
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-11-06
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  37. 2021-11-07
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  38. 2021-11-08
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  39. 2021-11-15
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-11-22
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  41. 2021-11-29
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  42. 2021-12-06
    Survey response — day 35, dose 3
    MedDRA: Ear discomfort, Epistaxis, Rhinorrhoea — Feeling: Fair
    Free text: Left ear is plugged and running nose at night, left nostril had blood. Believe it's due to weather and dryness in bedroom/house
    MedDRA releases: 2024-11 · check-in free text available
  43. 2021-12-15
    Survey response — day 42, dose 3
    MedDRA: Deafness unilateral, Ear infection, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Ear canal infection, loss of hearing in left ear. Have had medical care, and recovering now
    MedDRA releases: 2024-11 · check-in free text available
  44. 2021-12-15
    Report sent to call center — day 42, dose 3
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  45. 2021-12-16
  46. 2022-01-31
    Survey response — 3 months, dose 3
    MedDRA: Oropharyngeal pain, SARS-CoV-2 test negative, Sinus congestion — Feeling: Good
    Free text: Sore throat, severe sinus congestion. No fever, etc. sinus lasted about 5 days. Got PCR test on 16 Jan 22, Negative COVID.
    MedDRA releases: 2024-11 · check-in free text available
  47. 2022-04-09
    Dose 4 — Moderna
  48. 2022-04-19
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  49. 2022-04-23
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  50. 2022-04-30
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  51. 2022-05-07
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  52. 2022-05-14
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  53. 2022-05-21
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  54. 2022-07-09
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  55. 2022-10-08
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in
  56. 2023-04-09
    Survey response — 12 months, dose 4
    MedDRA: Cervical cord compression, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    MedDRA releases: 2024-11
  57. 2023-04-09
    Report sent to call center — 12 months, dose 4
    Get care from a doctor or other healthcare professional
    1 call case(s)
  58. 2023-04-10
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  59. 2023-04-10
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  60. 2023-04-10
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  61. 2023-04-10
    Call successful
    Does not wish to fill out VAERS report

Vaccinations

DoseDateManufacturerCo-administered
12021-03-02Moderna
22021-03-30Moderna
32021-11-01Moderna No
42022-04-09Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-04-27 Successful
2023-04-10
 Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-28 Successful
2023-04-10
 Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-12-15 Successful
2023-04-10
 Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-09 Successful
2023-04-10
 Does not wish to fill out VAERS report

Free text

Release 8 — day 28, dose 2

2021-04-27

Symptoms: Its due to my lower back and stenosis. Radiating pain up right chest area

Release 9 — 3 months, dose 2

2021-06-29

Symptoms: Severe cold - nasal and chest congestion

Release 9 — 6 months, dose 2

2021-09-28

Symptoms: Possibly had RSV in June. Spoke with my doctor and the symptoms were that of RSV and similar to COVID. Had a negative Covid test. Took approximately 3weeks to clear the cough and upper respiratory.
Healthcare visit (other): Doctor in neighborhood

Release 10 — day 35, dose 3

2021-12-06

Symptoms: Left ear is plugged and running nose at night, left nostril had blood. Believe it's due to weather and dryness in bedroom/house

Release 10 — day 42, dose 3

2021-12-15

Symptoms: Ear canal infection, loss of hearing in left ear. Have had medical care, and recovering now

Release 11 — 3 months, dose 3

2022-01-31

Symptoms: Sore throat, severe sinus congestion. No fever, etc. sinus lasted about 5 days. Got PCR test on 16 Jan 22, Negative 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

FieldPreferred term2021-092023-042024-11
HCVOMedical counselling · · ✓
HCVOOffice visit · · ✓
SDCervical cord compression · · ✓
SDChest pain ✓ ✓ ✓
SDCough · · ✓
SDDeafness unilateral · · ✓
SDEar discomfort · · ✓
SDEar infection · · ✓
SDEpistaxis · · ✓
SDMalaise · · ✓
SDNasal congestion ✓ ✓ ✓
SDOffice visit · · ✓
SDOropharyngeal pain · · ✓
SDRespiratory symptom · · ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDRhinorrhoea · · ✓
SDSARS-CoV-2 test negative · · ✓
SDSinus congestion · · ✓
SDStenosis ✓ ✓ ✓
SDUnevaluable event · · ✓

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

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