2HZ-28412-36605
4 vaccinations
6 coded responses
33 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 148 / NY
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-13
Registered in v-safe
-
2021-01-13
Dose 1 — Moderna
- 2021-01-13
- 2021-01-14
-
2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-01-18
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-01-19
- 2021-01-22
- 2021-01-27
- 2021-02-03
-
2021-02-12
Dose 2 — Moderna
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
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2021-02-18
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Musculoskeletal discomfort — Feeling: GoodFree text: Minor discomfort in shoulder radiating up neck for 3 days, may be related to shot I decidedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
-
2021-02-26
Survey response — day 14, dose 2MedDRA: Arthralgia, Neck pain — Feeling: GoodFree text: Right shoulder ache radiating up neck someMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-05-14
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2021-08-13
Survey response — 6 months, dose 2MedDRA: Bronchitis, Office visit, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: Bronchitis and sinus infection · Healthcare visit (other): Appointments in person with my own doctorMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-13
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-20
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2021-08-25
Call successfulDoes not wish to fill out VAERS report
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2021-10-29
Dose 3 — Moderna
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2022-02-12
Survey response — 12 months, dose 2MedDRA: COVID-19, SARS-CoV-2 test positive — Feeling: GoodFree text: Got Covid Dec 27, 11 members of family got sick within days after being with 2 positives for an hour early 12/25. My Home test 12/27 Was positive. PCR test two days later confirmed.MedDRA releases: 2024-11 · check-in free text available
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2022-05-03
Dose 4 — Moderna
- 2022-05-20
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-06-14
-
2022-08-02
Survey response — 3 months, dose 4MedDRA: Bronchitis, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Bronchitis and meds gave me a UTIMedDRA releases: 2024-11 · check-in free text available
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2022-08-02
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-08-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-11-02
Survey response — 6 months, dose 4MedDRA: Bronchitis, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Brochitis, sinusitisMedDRA releases: 2024-11 · check-in free text available
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2022-11-02
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-05-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-12 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-05-03 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Minor discomfort in shoulder radiating up neck for 3 days, may be related to shot I decided
Release 4 — day 14, dose 2
Symptoms: Right shoulder ache radiating up neck some
Release 9 — 6 months, dose 2
Symptoms: Bronchitis and sinus infection
Healthcare visit (other): Appointments in person with my own doctor
Release 11 — 12 months, dose 2
Symptoms: Got Covid Dec 27, 11 members of family got sick within days after being with 2 positives for an hour early 12/25. My Home test 12/27 Was positive. PCR test two days later confirmed.
Release 12 — 3 months, dose 4
Symptoms: Bronchitis and meds gave me a UTI
Release 12 — 6 months, dose 4
Symptoms: Brochitis, sinusitis
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Bronchitis | ✓ | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinusitis | ✓ | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Arthralgia | ○ | ✓ | ○ |
| SRO | Musculoskeletal discomfort | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release