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ZXL-20925-97749

4 vaccinations 5 coded responses 38 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
920 / CA
Registered
2021-02-09
Relationship
Self
Race
White
Ethnicity
N/A

Timeline

  1. 2021-01-21
    Dose 1 — Moderna
  2. 2021-02-09
    Registered in v-safe
  3. 2021-02-09
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  4. 2021-02-11
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-02-18
    Dose 2 — Moderna
  6. 2021-02-18
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  7. 2021-02-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  8. 2021-02-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  9. 2021-02-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-02-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-02-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-02-25
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-03-04
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-03-11
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-03-18
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-03-25
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-04-01
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-05-20
    Survey response — 3 months, dose 2
    MedDRA: Diarrhoea, Nausea — Feeling: Good
    Free text: 1 morning of diarrhea/afteroon queasy. This was 3 days after my husband spent a day in bed with same (but his was worse) & 2 days queasy. No fever for either. Attributed it to something we ate. Re my next response - I just laid low for day.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-08-19
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-10-22
    Dose 3 — Moderna
  22. 2021-10-24
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  23. 2021-10-25
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  24. 2021-10-26
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  25. 2021-10-27
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  26. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  27. 2021-10-29
    Survey response — day 7, dose 3
    MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Neurological issues but probably unrelated to vaccination. Being treated for issues related to spinal degeneration
    MedDRA releases: 2024-11 · check-in free text available
  28. 2021-11-05
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  29. 2021-11-12
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  30. 2021-11-21
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  31. 2021-11-26
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  32. 2021-12-03
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  33. 2022-01-21
    Survey response — 3 months, dose 3
    MedDRA: Upper-airway cough syndrome — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Post nasal drip
    MedDRA releases: 2024-11 · check-in free text available
  34. 2022-01-21
    Report sent to call center — 3 months, dose 3
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  35. 2022-01-26
  36. 2022-02-01
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  37. 2022-04-07
    Dose 4 — Moderna
  38. 2022-04-16
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  39. 2022-04-21
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  40. 2022-04-28
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  41. 2022-05-05
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  42. 2022-05-12
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  43. 2022-05-19
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  44. 2022-07-07
    Survey response — 3 months, dose 4
    MedDRA: Gastrointestinal disorder — Feeling: Good
    Free text: Gastric issues for 3 days. Started in Costa Rica and I think from fruit. Highly unlikely Covid as it was about day 14 of trip and minimal exposure to anyone.
    MedDRA releases: 2024-11 · check-in free text available
  45. 2022-10-06
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in
  46. 2023-04-09
    Survey response — 12 months, dose 4
    MedDRA: COVID-19, Upper respiratory tract infection — 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 visit
    MedDRA releases: 2024-11
  47. 2023-04-09
    Report sent to call center — 12 months, dose 4
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  48. 2023-04-10
    Call successful
    Completed over the phone

Vaccinations

DoseDateManufacturerCo-administered
12021-01-21Moderna
22021-02-18Moderna
32021-10-22Moderna No
42022-04-07Moderna No

Call center

2 call center cases

2 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 8 — 3 months, dose 2

2021-05-20

Symptoms: 1 morning of diarrhea/afteroon queasy. This was 3 days after my husband spent a day in bed with same (but his was worse) & 2 days queasy. No fever for either. Attributed it to something we ate. Re my next response - I just laid low for day.

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): Neurological issues but probably unrelated to vaccination. Being treated for issues related to spinal degeneration

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: Post nasal drip

Release 12 — 3 months, dose 4

2022-07-07

Symptoms: Gastric issues for 3 days. Started in Costa Rica and I think from fruit. Highly unlikely Covid as it was about day 14 of trip and minimal exposure to anyone.

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
SDCOVID-19 · · ✓
SDDiarrhoea ✓ ✓ ✓
SDGastrointestinal disorder · · ✓
SDNausea ✓ ✓ ✓
SDUpper respiratory tract infection · · ✓
SDUpper-airway cough syndrome · · ✓
SROPre-existing disease · · ✓

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

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