ZYY-12131-81145
2 vaccinations
8 coded responses
14 check-ins
8 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 982 / WA
- Registered
- 2021-04-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-19
Dose 1 — Moderna
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2021-04-16
Registered in v-safe
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2021-04-16
Dose 2 — Moderna
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2021-04-16
Survey response — day 0, dose 2MedDRA: Feeling abnormal — Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My thinking is kind of fuzzy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-17
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite, Eye pain, Influenza like illness, Pain of skin — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: No appetite, my eyes ache and the light bothers them, I feel like I have a very bad flu, even my skin hurts.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-18
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite, Memory impairment, Mental impairment — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: No appetite, memory and thinking is fuzzy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Anxiety, Decreased appetite, Depression — Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: No appetite, anxiety, hard to think, depressed,MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Headache, Fatigue or tirednessAdult check-in
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2021-04-21
Survey response — days 1–6 daily, dose 2MedDRA: Rash macular — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: I have had a circular shape, about an inch in diameter, that has a dark red rash made up of red pin point size spots that has been there for three days. It is on my left calve.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Still have a round area of rash on the back of my left leg.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
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2021-04-30
Survey response — day 14, dose 2MedDRA: Condition aggravated, Migraine, Pre-existing disease, Self-medication — Feeling: FairFree text: I have a migraine headache every day. I take my medication for my headaches which help take it away but it comes back the next day. They have increased since my last Moderna shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-07
Survey response — day 21, dose 2MedDRA: Arthritis, Condition aggravated, Fibromyalgia, Headache, Mobility decreased, Office visit, Pain in extremity, Pre-existing disease — Feeling: Fair · 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: Symptoms: My arthritis and Fibromyalgia has flaired up. My hands hurt so bad i can hardly use them. I have had an increase in headaches since my last vaccine. I was given Plaquenil for my arthritis. · Healthcare visit (other): Saw the Rheumatologist.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-07
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-16
- 2021-05-21
- 2021-05-29
- 2021-07-16
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2022-04-15
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-19 | Moderna | |
| 2 | 2021-04-16 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 7 — day 0, dose 2
Systemic reaction (other): My thinking is kind of fuzzy.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): No appetite, my eyes ache and the light bothers them, I feel like I have a very bad flu, even my skin hurts.
Systemic reaction (other): No appetite, memory and thinking is fuzzy.
Systemic reaction (other): No appetite, anxiety, hard to think, depressed,
Systemic reaction (other): I have had a circular shape, about an inch in diameter, that has a dark red rash made up of red pin point size spots that has been there for three days. It is on my left calve.
Systemic reaction (other): Still have a round area of rash on the back of my left leg.
Release 8 — day 14, dose 2
Symptoms: I have a migraine headache every day. I take my medication for my headaches which help take it away but it comes back the next day. They have increased since my last Moderna shot.
Release 8 — day 21, dose 2
Symptoms: My arthritis and Fibromyalgia has flaired up. My hands hurt so bad i can hardly use them. I have had an increase in headaches since my last vaccine. I was given Plaquenil for my arthritis.
Healthcare visit (other): Saw the Rheumatologist.
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 | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Fibromyalgia | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Migraine | ✓ | ✓ | ✓ |
| SD | Mobility decreased | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Depression | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Influenza like illness | ✓ | ✓ | ✓ |
| SRO | Memory impairment | ✓ | ✓ | ✓ |
| SRO | Mental impairment | ✓ | ✓ | ✓ |
| SRO | Pain of skin | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash macular | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release