ZTA-15200-56667
5 vaccinations
17 coded responses
29 check-ins
17 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 490 / MI
- Registered
- 2021-10-29
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
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2020-12-28
Dose 1 — Moderna
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2021-01-27
Dose 2 — Moderna
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2021-10-29
Registered in v-safe
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2021-10-29
Dose 3 — Moderna
- 2021-10-29
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2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion — Feeling: Good · Site: Pain · Joint painsFree text: Stuffy noseMedDRA releases: 2024-11 · check-in free text available
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2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: Stuffy noseMedDRA releases: 2024-11 · check-in free text available
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2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Rhinorrhoea — Feeling: GoodFree text: Very slight runny nose, better than yesterdayMedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Headache, Migraine, Pain, Pain in extremity — Feeling: Fair · Headache, Joint painsFree text: Woke with headache this morning turning into migraine but could be related to the weather changes. Pain in my feet while walking which started last night and still going on but not as bad.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-03
- 2021-11-04
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2021-11-05
Survey response — day 7, dose 3MedDRA: Headache, Neck pain — Feeling: Good · HeadacheFree text: Headache and neck pain probably from weather thoughMedDRA releases: 2024-11 · check-in free text available
- 2021-11-12
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2021-11-19
Survey response — day 21, dose 3MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
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2021-11-26
Survey response — day 28, dose 3MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
- 2021-12-03
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2021-12-10
Survey response — day 42, dose 3MedDRA: Asthma, Dyspnoea, Nasal congestion, Rash, Sinus headache — Feeling: GoodFree text: Nose a little stuffy and mild sinus headache. Also a little shortness of breath but maybe from my asthma. Still have rash on my feet but it is starting to respond to antibiotic cream after trying antifungal and steroid creams and other treatments)MedDRA releases: 2024-11 · check-in free text available
- 2022-01-28
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2022-04-30
Survey response — 6 months, dose 3MedDRA: Pyrexia — Feeling: GoodFree text: Low grade fever about a month ago for about 2 weeks, but no Covid on two checks a week apartMedDRA releases: 2024-11 · check-in free text available
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2022-05-06
Dose 4 — Moderna
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2022-05-12
Survey response — days 1–6 daily, dose 4MedDRA: Ear pain, Eustachian tube dysfunction, Infection — Feeling: Good · HeadacheFree text: Left Eustachian tube dysfunction and ear pain, but had prior to infection but a little more.MedDRA releases: 2024-11 · check-in free text available
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2022-05-15
Survey response — day 7, dose 4MedDRA: Pre-existing disease — Feeling: GoodFree text: Just the continued Eustachian tube disorder not healing but had prior to shotMedDRA releases: 2024-11 · check-in free text available
- 2022-05-20
- 2022-05-29
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2022-06-03
Survey response — day 28, dose 4MedDRA: Body temperature increased, Cyst, Nasal congestion — Feeling: GoodFree text: Stuffy nose but may be from allergies. Low grade temp (wouldn't know if not checking temps at office -99.4) and a cyst in the left nostrilMedDRA releases: 2024-11 · check-in free text available
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2022-06-10
Survey response — day 35, dose 4MedDRA: Ear disorder, Eustachian tube dysfunction, Nasal congestion, Rash — Feeling: GoodFree text: Stuffy nose, rash on foot is spreading. Found out Eustachian tube dysfunction is from mold in earMedDRA releases: 2024-11 · check-in free text available
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2022-06-17
Survey response — day 42, dose 4MedDRA: Cough, Paranasal sinus hypersecretion — Feeling: FairFree text: Drainage in the back of the throat more than usual and a dry coughMedDRA releases: 2024-11 · check-in free text available
- 2022-08-05
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2022-09-21
Dose 5 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-28
- 2022-10-07
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2022-10-14
Survey response — day 21, dose 5MedDRA: Chest discomfort, Chest pain, Dyspnoea — Feeling: FairFree text: Shortness of breath, some chest discomfort/catchMedDRA releases: 2024-11 · check-in free text available
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2022-10-26
Survey response — day 35, dose 5MedDRA: Fatigue, Heart rate increased, Nasal congestion — Feeling: GoodFree text: Stuffy nose but may be allergies. A little more tired. Fast heart rate a few times.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-02
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2022-12-23
Survey response — 3 months, dose 5MedDRA: Back pain, Chills, Headache, Hyperacusis, Nasal congestion, Neck pain, Oropharyngeal pain, Photophobia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Headache with sensitivity to light and sound, neck pain, chills, sore throat, neck pain, back pain, stuffy noseMedDRA releases: 2024-11 · check-in free text available
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2022-12-23
Report sent to call center — 3 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-27
- 2022-12-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | No |
| 2 | 2021-01-27 | Moderna | No |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-05-06 | Moderna | No |
| 5 | 2022-09-21 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-23 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Stuffy nose
Systemic reaction (other): Stuffy nose
Systemic reaction (other): Very slight runny nose, better than yesterday
Systemic reaction (other): Woke with headache this morning turning into migraine but could be related to the weather changes. Pain in my feet while walking which started last night and still going on but not as bad.
Release 10 — day 7, dose 3
Systemic reaction (other): Headache and neck pain probably from weather though
Release 10 — day 21, dose 3
Symptoms: Runny nose
Release 10 — day 28, dose 3
Symptoms: Runny nose
Release 10 — day 42, dose 3
Symptoms: Nose a little stuffy and mild sinus headache. Also a little shortness of breath but maybe from my asthma. Still have rash on my feet but it is starting to respond to antibiotic cream after trying antifungal and steroid creams and other treatments)
Release 11 — 6 months, dose 3
Symptoms: Low grade fever about a month ago for about 2 weeks, but no Covid on two checks a week apart
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Left Eustachian tube dysfunction and ear pain, but had prior to infection but a little more.
Release 11 — day 7, dose 4
Systemic reaction (other): Just the continued Eustachian tube disorder not healing but had prior to shot
Release 11 — day 28, dose 4
Symptoms: Stuffy nose but may be from allergies. Low grade temp (wouldn't know if not checking temps at office -99.4) and a cyst in the left nostril
Release 12 — day 35, dose 4
Symptoms: Stuffy nose, rash on foot is spreading. Found out Eustachian tube dysfunction is from mold in ear
Release 12 — day 42, dose 4
Symptoms: Drainage in the back of the throat more than usual and a dry cough
Release 12 — day 21, dose 5
Symptoms: Shortness of breath, some chest discomfort/catch
Release 12 — day 35, dose 5
Symptoms: Stuffy nose but may be allergies. A little more tired. Fast heart rate a few times.
Release 12 — 3 months, dose 5
Symptoms: Headache with sensitivity to light and sound, neck pain, chills, sore throat, neck pain, back pain, stuffy nose
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 | Asthma | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Cyst | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Ear disorder | · | · | ✓ |
| SD | Eustachian tube dysfunction | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Heart rate increased | · | · | ✓ |
| SD | Hyperacusis | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Photophobia | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sinus headache | · | · | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | Eustachian tube dysfunction | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Infection | · | · | ✓ |
| SRO | Migraine | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Neck pain | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release