ZUJ-29820-73374
5 vaccinations
5 coded responses
49 check-ins
5 free-text entries
3 call cases
- Sex
- —
- Age at first dose
- 66+
- ZIP prefix
- 853 / AZ
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Registered in v-safe
-
2021-02-05
Dose 1 — Moderna
- 2021-02-05
-
2021-02-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal painAdult check-in
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
-
2021-02-19
Survey response — day 14, dose 1MedDRA: Gingival swelling, Oral mucosal eruption, Pre-existing disease — Feeling: GoodFree text: My swollen gums - sorry didn't realize that was a symptom - and slight rash is Covid mouth per my dentist. I have sensitive skin and allergies. Didn't think it was a symptom.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
-
2021-03-05
Dose 2 — Moderna
- 2021-03-05
-
2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Gingival swelling — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Swollen gumsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
-
2021-04-16
Survey response — day 42, dose 2MedDRA: Office visit, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I had a UTI. I only have two others. Didn't think much of the UTI. I'm old. Stuff happens. But now I found out my Aunt in Michigan and an x-ray tech at Core both had It is after 2nd shot. · Healthcare visit (other): At PCP office.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-16
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-04
-
2021-08-29
Dose 3 — Moderna
- 2021-09-03
-
2022-02-24
Call successfulParticipant prefers to complete VAERS report online
- 2022-03-05
-
2022-03-05
Survey response — 12 months, dose 2MedDRA: Arthritis, Blood pressure increased, Gout, Pre-existing disease, Weight decreased — Feeling: Good · 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: Nothing to do with Covid. Arthritis is worse, Gout is worse, blood pressure is higher, blood pressure is higher. Ive lost a few pounds, does that count?MedDRA releases: 2024-11 · check-in free text available
-
2022-03-05
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-14
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-03-25
Dose 4 — Moderna
- 2022-04-14
- 2022-04-15
- 2022-04-24
- 2022-04-29
- 2022-05-06
- 2022-06-26
-
2022-09-23
Survey response — 6 months, dose 4MedDRA: Dry eye, Office visit, Optic neuropathy — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Nothing to do with shots: Dry eye, optic nerve neuropathy · Healthcare visit (other): In office visitMedDRA releases: 2024-11 · check-in free text available
-
2022-09-23
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2022-09-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-21
Dose 5 — Moderna
- 2022-10-21
-
2022-10-22
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-23
- 2022-10-24
- 2022-10-25
- 2022-10-26
- 2022-10-27
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-11-18
- 2022-11-27
- 2022-12-02
- 2023-01-22
- 2023-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | |
| 2 | 2021-03-05 | Moderna | |
| 3 | 2021-08-29 | Moderna | No |
| 4 | 2022-03-25 | Moderna | No |
| 5 | 2022-10-21 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 4 — day 14, dose 1
Symptoms: My swollen gums - sorry didn't realize that was a symptom - and slight rash is Covid mouth per my dentist. I have sensitive skin and allergies. Didn't think it was a symptom.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Swollen gums
Release 7 — day 42, dose 2
Symptoms: I had a UTI. I only have two others. Didn't think much of the UTI. I'm old. Stuff happens. But now I found out my Aunt in Michigan and an x-ray tech at Core both had It is after 2nd shot.
Healthcare visit (other): At PCP office.
Release 11 — 12 months, dose 2
Symptoms: Nothing to do with Covid. Arthritis is worse, Gout is worse, blood pressure is higher, blood pressure is higher. Ive lost a few pounds, does that count?
Release 12 — 6 months, dose 4
Symptoms: Nothing to do with shots: Dry eye, optic nerve neuropathy
Healthcare visit (other): In office visit
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Arthritis | · | · | ✓ |
| SD | Blood pressure increased | · | · | ✓ |
| SD | Dry eye | · | · | ✓ |
| SD | Gingival swelling | ✓ | ✓ | ✓ |
| SD | Gout | · | · | ✓ |
| SD | Optic neuropathy | · | · | ✓ |
| SD | Oral mucosal eruption | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Urinary tract infection | ✓ | ✓ | ✓ |
| SD | Weight decreased | · | · | ✓ |
| SRO | Gingival swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release