ZVB-18203-04880
3 vaccinations
16 coded responses
39 check-ins
16 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 36-40
- ZIP prefix
- 917 / CA
- Registered
- 2021-03-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
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2021-03-12
Dose 1 — Moderna
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2021-03-13
Registered in v-safe
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2021-03-13
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal pain upper, Feeling hot, Injection site pain, Nausea — Feeling: Poor · Site: Pain · Fever · Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesFree text: I feel hot at times but mainly I feel pain at the injection site and stomach pains/nauseaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Insomnia — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Not sleeping wellMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal discomfort, Fatigue — Feeling: Fair · Fatigue or tirednessFree text: Very tired. It doesnt feel as though I have been sleeping well. I nearly called out of work today. When I went home for lunch, I didnt think I would make it back to work. I felt exhausted. But I sat down and closed my eyes for a while and got second wind. So it was mild but close to moderate at times. No diarrhea today again although my stomach feels a little off at the moment.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal discomfort, Abdominal pain — Feeling: Fair · Abdominal painFree text: Yesterday afternoon and throughout the night I had an upset stomach/abdominal pain. It only felt better when I stayed still and didnt move around. Today has been better. My stomach was in mood earlier but is fine at the moment. I really hope it stays that way.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal discomfort, Nervousness — Feeling: GoodFree text: Feel better today. No lingering stomach issues. Nervous about second vaccination. I read that the side effects can be worse the second time around.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
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2021-04-10
Dose 2 — Moderna
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2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Insomnia, Loss of personal independence in daily activities, Pain in extremity — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activitiesFree text: The pain in my arm felt moderate yesterday and during sleep. Surprisingly, I actually woke up with less pain. I also had difficulty sleeping last night. Today, I have tried to rest as much as possible. I tried to be outside and water my yard but I couldnt do it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain — Feeling: Fair · Site: Pain · Abdominal painFree text: Intermittent pain on the left side of my bellyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Self-medication — Feeling: Fair · Headache, Nausea · Be unable to do your normal daily activitiesFree text: I had a very bad headache that began when I woke up and grew worse as the day went on. It improved about 2pm a couple of hours after taking extra strength Tylenol. But it was concerning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-24
- 2021-05-01
- 2021-05-08
- 2021-05-15
- 2021-05-22
- 2021-07-10
- 2021-10-09
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2021-12-20
Dose 3 — Moderna
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2021-12-20
Survey response — day 0, dose 3MedDRA: No adverse event — Feeling: Fair · Site: Pain · Be unable to do your normal daily activitiesFree text: NoneMedDRA releases: 2024-11 · check-in free text available
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2021-12-21
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
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2021-12-22
Survey response — days 1–6 daily, dose 3MedDRA: Headache, Nausea — Feeling: Good · Site: Pain · NauseaFree text: Last night after I submitted my check-in yesterday I developed a painful headache before bed and felt nauseatedMedDRA releases: 2024-11 · check-in free text available
- 2021-12-23
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2021-12-24
Survey response — days 1–6 daily, dose 3MedDRA: Abdominal pain upper, Nausea — Feeling: Fair · Nausea, Abdominal painFree text: It feels like I want to vomit all day but I don't. Stomach pain makes it worse. When will this end?MedDRA releases: 2024-11 · check-in free text available
- 2021-12-25
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2021-12-26
Survey response — days 1–6 daily, dose 3MedDRA: Nausea — Feeling: Fair · NauseaFree text: Since last Wednesday, it feels as though I want to throw up. I feel it in my throat but it goes no further than that. I experience this sensation throughout the day.MedDRA releases: 2024-11 · check-in free text available
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2021-12-27
Survey response — day 7, dose 3MedDRA: Nausea, Oropharyngeal discomfort — Feeling: Fair · Headache, Fatigue or tiredness, NauseaFree text: I continue to have the sensation of needing to throw up. I feel it in my throat; the way it does when you're about to throw up. Except I don't. But the feeling is there throughout the day and it is difficult to deal withMedDRA releases: 2024-11 · check-in free text available
- 2022-01-03
- 2022-01-10
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2022-01-19
Survey response — day 28, dose 3MedDRA: Nausea — Feeling: GoodFree text: Sometime I get bad nausea and the feeling of needing to throw upMedDRA releases: 2024-11 · check-in free text available
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2022-01-24
Survey response — day 35, dose 3MedDRA: Salivary hypersecretion — Feeling: GoodFree text: Since yesterday, I have been experiencing an excess of saliva in my mouth.MedDRA releases: 2024-11 · check-in free text available
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2022-01-31
Survey response — day 42, dose 3MedDRA: Salivary hypersecretion, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Excess saliva · Healthcare visit (other): Will schedule a follow up in person visitMedDRA releases: 2024-11 · check-in free text available
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2022-01-31
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-02-03
Call successfulParticipant prefers to complete VAERS report online
- 2022-06-20
- 2022-12-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna | |
| 2 | 2021-04-10 | Moderna | |
| 3 | 2021-12-20 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): I feel hot at times but mainly I feel pain at the injection site and stomach pains/nausea
Systemic reaction (other): Not sleeping well
Systemic reaction (other): Very tired. It doesnt feel as though I have been sleeping well. I nearly called out of work today. When I went home for lunch, I didnt think I would make it back to work. I felt exhausted. But I sat down and closed my eyes for a while and got second wind. So it was mild but close to moderate at times. No diarrhea today again although my stomach feels a little off at the moment.
Systemic reaction (other): Yesterday afternoon and throughout the night I had an upset stomach/abdominal pain. It only felt better when I stayed still and didnt move around. Today has been better. My stomach was in mood earlier but is fine at the moment. I really hope it stays that way.
Systemic reaction (other): Feel better today. No lingering stomach issues. Nervous about second vaccination. I read that the side effects can be worse the second time around.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): The pain in my arm felt moderate yesterday and during sleep. Surprisingly, I actually woke up with less pain. I also had difficulty sleeping last night. Today, I have tried to rest as much as possible. I tried to be outside and water my yard but I couldnt do it.
Systemic reaction (other): Intermittent pain on the left side of my belly
Systemic reaction (other): I had a very bad headache that began when I woke up and grew worse as the day went on. It improved about 2pm a couple of hours after taking extra strength Tylenol. But it was concerning.
Release 10 — day 0, dose 3
Systemic reaction (other): None
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Last night after I submitted my check-in yesterday I developed a painful headache before bed and felt nauseated
Systemic reaction (other): It feels like I want to vomit all day but I don't. Stomach pain makes it worse. When will this end?
Systemic reaction (other): Since last Wednesday, it feels as though I want to throw up. I feel it in my throat but it goes no further than that. I experience this sensation throughout the day.
Release 10 — day 7, dose 3
Systemic reaction (other): I continue to have the sensation of needing to throw up. I feel it in my throat; the way it does when you're about to throw up. Except I don't. But the feeling is there throughout the day and it is difficult to deal with
Release 10 — day 28, dose 3
Symptoms: Sometime I get bad nausea and the feeling of needing to throw up
Release 11 — day 35, dose 3
Symptoms: Since yesterday, I have been experiencing an excess of saliva in my mouth.
Release 11 — day 42, dose 3
Symptoms: Excess saliva
Healthcare visit (other): Will schedule a follow up in person 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 | Unevaluable event | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Salivary hypersecretion | · | · | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Abdominal pain upper | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Nervousness | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Oropharyngeal discomfort | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release