2YR-19016-16117
5 vaccinations
4 coded responses
45 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 954 / CA
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-11
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body achesAdult check-in
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-01-29
- 2021-01-31
- 2021-02-03
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-09
- 2021-04-26
- 2021-07-26
-
2021-11-27
Dose 3 — Moderna
- 2022-01-25
-
2022-04-06
Dose 4 — Moderna
-
2022-04-22
Survey response — day 14, dose 4MedDRA: Acupuncture, Arthralgia, Injected limb mobility decreased, Insomnia, Pain — 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 visitFree text: Symptoms: Got 4 Th booster shot and got severe pain in my left shoulder and was unable to move it beyond shoulder height for 7 days, couldn't sleep due to the pain. On the 7th day the pain went away and motion returned like nothing had happened! · Healthcare visit (other): Went for acupunctureMedDRA releases: 2024-11 · check-in free text available
-
2022-04-22
Report sent to call center — day 14, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-27
- 2022-04-28
- 2022-04-29
- 2022-05-03
-
2022-05-03
Callback requested for01:30PM CT
- 2022-05-04
-
2022-05-04
Call successfulParticipant prefers to complete VAERS report online
- 2022-05-12
- 2022-05-18
-
2022-07-06
Survey response — 3 months, dose 4MedDRA: Diarrhoea, Exposure to SARS-CoV-2, Nasopharyngitis, Poor quality sleep, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activitiesFree text: I was around someone on Monday that tested positive for Covid today. I test negative for Covid but I woke up feeling like I have a really bad cold, not sleeping well, loose stoolsMedDRA releases: 2024-11 · check-in free text available
-
2022-09-17
Dose 5 — ModernaCo-administered: Flu
-
2022-09-17
Health check-in — day 0, dose 5Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-09-18
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-09-19
-
2022-09-20
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-09-21
- 2022-09-23
- 2022-09-24
- 2022-10-01
- 2022-10-08
-
2022-10-15
Survey response — day 28, dose 5MedDRA: Body temperature increased, Fatigue, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Developed a fever 99.9, cold like symptoms and fatigue on 9/11.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-22
Survey response — day 35, dose 5MedDRA: Impaired work ability, Ophthalmic migraine, Oropharyngeal pain, Photophobia, Pre-existing disease, Rhinorrhoea, Vertigo — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I had a bad optical migraine causing everything to spin and I missed a day of work, it has to do with exposure to light, not the vaccine. Today is very windy and I am getting some allergy sniffles and a bit of a sore throat after working out sideMedDRA releases: 2024-11 · check-in free text available
- 2022-10-29
- 2022-12-17
- 2023-03-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna | |
| 3 | 2021-11-27 | Moderna | No |
| 4 | 2022-04-06 | Moderna | No |
| 5 | 2022-09-17 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 11 — day 14, dose 4
Symptoms: Got 4 Th booster shot and got severe pain in my left shoulder and was unable to move it beyond shoulder height for 7 days, couldn't sleep due to the pain. On the 7th day the pain went away and motion returned like nothing had happened!
Healthcare visit (other): Went for acupuncture
Release 12 — 3 months, dose 4
Symptoms: I was around someone on Monday that tested positive for Covid today. I test negative for Covid but I woke up feeling like I have a really bad cold, not sleeping well, loose stools
Release 12 — day 28, dose 5
Symptoms: Developed a fever 99.9, cold like symptoms and fatigue on 9/11.
Release 12 — day 35, dose 5
Symptoms: I had a bad optical migraine causing everything to spin and I missed a day of work, it has to do with exposure to light, not the vaccine. Today is very windy and I am getting some allergy sniffles and a bit of a sore throat after working out side cut off by CDC
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 | Acupuncture | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Impaired work ability | · | · | ✓ |
| SD | Injected limb mobility decreased | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Ophthalmic migraine | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Photophobia | · | · | ✓ |
| SD | Poor quality sleep | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vertigo | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release