2S3-31118-65981
4 vaccinations
4 coded responses
48 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 931 / CA
- Registered
- 2021-02-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-20
Dose 1 — Moderna
-
2021-02-21
Registered in v-safe
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-03-01
- 2021-03-06
- 2021-03-13
- 2021-03-20
-
2021-03-21
Dose 2 — Moderna
- 2021-03-21
-
2021-03-22
Survey response — days 1–6 daily, dose 2MedDRA: Condition aggravated, Heart rate irregular, Pre-existing disease, Ventricular extrasystoles — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Aggravation of irregular heartbeat due to premature ventricular contraction conditionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-24
-
2021-03-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-04-04
- 2021-04-11
- 2021-04-18
- 2021-04-25
- 2021-05-02
- 2021-06-20
- 2021-09-19
-
2021-11-02
Dose 3 — Moderna
-
2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Extrasystoles — Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Ectopic heart rhythmMedDRA releases: 2024-11 · check-in free text available
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
-
2021-11-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2022-02-01
-
2022-04-11
Dose 4 — Moderna
-
2022-04-15
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-25
- 2022-05-04
- 2022-05-09
-
2022-05-16
Survey response — day 35, dose 4MedDRA: Cough, Ear pruritus, Fatigue, Headache, Malaise, Medical counselling, Respiratory tract congestion, SARS-CoV-2 test positive, Throat irritation — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Tested positive for covid on Sunday. Symptoms include; headache, itchy ears, scratchy throat, congestion, slight cough, general fatigue and feeling ill. All symptoms mild to moderate · Healthcare visit (other): Checked in with on-call nurse and physician, was advised to take meds to treat symptoms. No antiviral treatment recommended.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-16
Report sent to call center — day 35, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-05-17
- 2022-05-23
-
2022-07-12
Survey response — 3 months, dose 4MedDRA: Cough, Respiratory tract congestion — Feeling: GoodFree text: Cough , congestionMedDRA releases: 2024-11 · check-in free text available
- 2022-10-10
- 2023-04-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-20 | Moderna | |
| 2 | 2021-03-21 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-04-11 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-16 | Unsuccessful |
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Aggravation of irregular heartbeat due to premature ventricular contraction condition
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Ectopic heart rhythm
Release 11 — day 35, dose 4
Symptoms: Tested positive for covid on Sunday. Symptoms include; headache, itchy ears, scratchy throat, congestion, slight cough, general fatigue and feeling ill. All symptoms mild to moderate
Healthcare visit (other): Checked in with on-call nurse and physician, was advised to take meds to treat symptoms. No antiviral treatment recommended.
Release 12 — 3 months, dose 4
Symptoms: Cough , congestion
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 | Medical counselling | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Ear pruritus | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Extrasystoles | · | · | ✓ |
| SRO | Heart rate irregular | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Ventricular extrasystoles | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release