3CS-16721-79522
4 vaccinations
4 coded responses
54 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 902 / CA
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-18
Registered in v-safe
-
2021-01-18
Dose 1 — Moderna
-
2021-01-18
Survey response — day 0, dose 1MedDRA: Hypoaesthesia, Immediate post-injection reaction — Feeling: Good · Site: Pain · Headache, Fatigue or tirednessFree text: Numbness in left arm (injected in left shoulder) and numbness in face. Both lasted very briefly (1-2 minutes) and occurred within 30 minutes of vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-19
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
-
2021-01-20
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-02-01
- 2021-02-08
-
2021-02-15
Dose 2 — Moderna
- 2021-02-15
-
2021-02-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tirednessAdult check-in
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-05-17
- 2021-08-16
-
2021-11-07
Dose 3 — Moderna
- 2021-11-07
-
2021-11-08
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-11-09
- 2021-11-10
- 2021-11-11
- 2021-11-12
- 2021-11-13
- 2021-11-14
- 2021-11-22
- 2021-11-28
- 2021-12-05
- 2021-12-12
- 2021-12-19
- 2022-02-06
- 2022-05-08
-
2022-09-09
Dose 4 — Moderna
-
2022-09-09
Survey response — day 0, dose 4MedDRA: Hypoaesthesia — Feeling: Good · Site: PainFree text: Numbness in injection site arm, dissipated within 30 minsMedDRA releases: 2024-11 · check-in free text available
- 2022-09-10
- 2022-09-11
- 2022-09-12
- 2022-09-13
- 2022-09-14
- 2022-09-16
- 2022-09-23
- 2022-09-30
- 2022-10-07
- 2022-10-14
-
2022-10-21
Survey response — day 42, dose 4MedDRA: Vertigo — Feeling: Fair · Be unable to work or attend school, 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: Severe vertigo starting 10/18. Much improved for past couple of days. Idiopathic, no history of vertigo before.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-21
Report sent to call center — day 42, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-10-24
-
2022-10-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-12-09
Survey response — 3 months, dose 4MedDRA: Fatigue, Headache, Muscle spasms, Nausea, Pregnancy — 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 consultationFree text: Pregnancy and all the symptoms that come with it - nausea, cramps, fatigue, headache, etc.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-09
Report sent to call center — 3 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 · 1 call case(s)
- 2022-12-12
- 2023-03-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-18 | Moderna | |
| 2 | 2021-02-15 | Moderna | |
| 3 | 2021-11-07 | Moderna | No |
| 4 | 2022-09-09 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-21 | Successful 2022-10-24 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-12-09 | Unsuccessful |
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): Numbness in left arm (injected in left shoulder) and numbness in face. Both lasted very briefly (1-2 minutes) and occurred within 30 minutes of vaccine.
Release 12 — day 0, dose 4
Systemic reaction (other): Numbness in injection site arm, dissipated within 30 mins
Release 12 — day 42, dose 4
Symptoms: Severe vertigo starting 10/18. Much improved for past couple of days. Idiopathic, no history of vertigo before.
Release 12 — 3 months, dose 4
Symptoms: Pregnancy and all the symptoms that come with it - nausea, cramps, fatigue, headache, etc.
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 | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Vertigo | · | · | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release