39D-30091-50218
5 vaccinations
8 coded responses
41 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 787 / TX
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Dose 1 — Moderna
-
2021-01-25
Registered in v-safe
- 2021-01-25
- 2021-01-26
- 2021-02-02
- 2021-02-09
- 2021-02-16
-
2021-02-23
Dose 2 — Moderna
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2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased — Feeling: Fair · Site: Pain, Redness · Fever · Fatigue or tirednessFree text: Last night I had 101 degrees on my thermometer.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Nasopharyngitis — Feeling: Fair · Site: Pain, Redness, Itching · Fever · Muscle or body aches, Fatigue or tirednessFree text: I have been cold all day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · Fatigue or tirednessAdult check-in
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-10
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-07
-
2021-05-25
Survey response — 3 months, dose 2MedDRA: Brain fog, Feeling abnormal — Feeling: Good · Be unable to do your normal daily activitiesFree text: 2 months after my last vaccine(dose 2) It was like I had come out of a fog. Felt much , much better than I had in 2 months. I had been droopy for 2 months and did not realize it! Since I was still staying at home because of COVID, I did not notice.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-24
-
2021-10-23
Dose 3 — Moderna
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Injection site erythema, Injection site pain, Myalgia, Pain, Pyrexia — Feeling: Good · Site: RednessFree text: Late afternoon on October 24 I experienced aches, fever , soreness and redness at the injection site and aching in the muscles of my back and shoulder. Fever also.MedDRA releases: 2024-11 · check-in free text available
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2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Erythema, Peripheral swelling — Feeling: Good · Site: Redness, SwellingFree text: Seems like the redness and swelling has not gotten larger but moved about one half inch down my arm. Might be caused because I spent 3 hours bending over picking up limbs and pulling weeds.MedDRA releases: 2024-11 · check-in free text available
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2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Erythema — Feeling: Good · Site: Redness, ItchingFree text: Redness is fading as of today 10/28/2021MedDRA releases: 2024-11 · check-in free text available
- 2021-10-29
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2022-01-22
-
2022-04-01
Dose 4 — Moderna
- 2022-04-15
- 2022-04-22
- 2022-05-01
-
2022-05-06
Survey response — day 35, dose 4MedDRA: Blood disorder, Office visit — Feeling: GoodFree text: Blood problems. I was to a hematologist; had an appointment Wednesday, May 4,2022. I haven't heard back from the blood work yet. I expect someone will call in the next few days with a report or a follow-up appointment.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-13
- 2022-07-03
-
2022-09-12
Dose 5 — Moderna
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2022-09-30
Survey response — 6 months, dose 4MedDRA: Injection site swelling, Pre-existing disease, Respiratory symptom — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Received booster on 09/13/22 no problems; received flu shot 09/20/2022 large raised spot at site of injection; no other reaction. Had a reaction to dog dander (known allergies to dog dander) followed by upper respiratory involvementMedDRA releases: 2024-11 · check-in free text available
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2022-09-30
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-10-03
Call successfulParticipant prefers to complete VAERS report online
- 2022-10-11
- 2022-10-17
- 2022-10-24
- 2022-12-12
- 2023-03-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-23 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-01 | Moderna | No |
| 5 | 2022-09-12 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Last night I had 101 degrees on my thermometer.
Systemic reaction (other): I have been cold all day.
Release 8 — 3 months, dose 2
Symptoms: 2 months after my last vaccine(dose 2) It was like I had come out of a fog. Felt much , much better than I had in 2 months. I had been droopy for 2 months and did not realize it! Since I was still staying at home because of COVID, I did not notice. cut off by CDC
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Late afternoon on October 24 I experienced aches, fever , soreness and redness at the injection site and aching in the muscles of my back and shoulder. Fever also.
Systemic reaction (other): Seems like the redness and swelling has not gotten larger but moved about one half inch down my arm. Might be caused because I spent 3 hours bending over picking up limbs and pulling weeds.
Systemic reaction (other): Redness is fading as of today 10/28/2021
Release 11 — day 35, dose 4
Symptoms: Blood problems. I was to a hematologist; had an appointment Wednesday, May 4,2022. I haven't heard back from the blood work yet. I expect someone will call in the next few days with a report or a follow-up appointment.
Release 12 — 6 months, dose 4
Symptoms: Received booster on 09/13/22 no problems; received flu shot 09/20/2022 large raised spot at site of injection; no other reaction. Had a reaction to dog dander (known allergies to dog dander) followed by upper respiratory involvement
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 | Blood disorder | · | · | ✓ |
| SD | Brain fog | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Injection site swelling | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory symptom | · | · | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Erythema | · | · | ✓ |
| SRO | Injection site erythema | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Nasopharyngitis | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Peripheral swelling | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release