ZXX-25747-95105
1 vaccination
2 coded responses
12 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 957 / CA
- Registered
- 2021-02-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-02-08
Registered in v-safe
-
2021-02-08
Dose 1 — Moderna
- 2021-02-08
- 2021-02-09
-
2021-02-10
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: the above sypmtoms occured last nijgt after i filled out this questionnaire yeaterday. no symptoms today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-05-10
- 2021-08-09
-
2022-02-08
Survey response — 12 months, dose 1MedDRA: COVID-19, Headache, Nasal pruritus, Oropharyngeal pain, Rhinorrhoea — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: sore throat, runny itxhy nose, headache and was diagnosed with covid in JanuaryMedDRA releases: 2024-11 · check-in free text available
-
2022-02-08
Report sent to call center — 12 months, dose 1Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-02-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-08 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-08 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): the above sypmtoms occured last nijgt after i filled out this questionnaire yeaterday. no symptoms today.
Release 11 — 12 months, dose 1
Symptoms: sore throat, runny itxhy nose, headache and was diagnosed with covid in January
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 | COVID-19 | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasal pruritus | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release