3DY-29820-67771
4 vaccinations
4 coded responses
38 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 787 / TX
- Registered
- 2021-01-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-01
Registered in v-safe
-
2021-01-01
Dose 1 — Moderna
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-15
- 2021-01-22
-
2021-01-29
Dose 2 — Moderna
- 2021-01-29
- 2021-01-30
-
2021-01-31
Survey response — days 1–6 daily, dose 2MedDRA: Myalgia — Feeling: Good · Site: Pain · Muscle or body achesFree text: Muscle soreness only after Pilates which disappeared after 10 minutes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
-
2021-04-30
Survey response — 3 months, dose 2MedDRA: Arthralgia, Myalgia, Office visit, Tendon pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Severe muscle aches on quads and knees. Acute pain at tendon insertion points above knees. Knee joints extremely painful · Healthcare visit (other): Im person visits with my orthopedist. MRIs takenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-30
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-30
-
2021-08-21
Dose 3 — ModernaCo-administered: Flu
- 2021-11-20
- 2022-02-19
-
2022-04-14
Call successfulParticipant prefers to complete VAERS report online
-
2022-05-07
Dose 4 — Moderna
-
2022-05-11
Survey response — days 1–6 daily, dose 4MedDRA: Arthritis — Feeling: Good · Be unable to do your normal daily activitiesFree text: Glare of arthritis, possibly RA, unknown prior to immunizations . Began 2 months after initial doseMedDRA releases: 2024-11 · check-in free text available
- 2022-05-12
- 2022-05-13
- 2022-05-14
- 2022-05-21
- 2022-05-28
-
2022-06-05
Survey response — day 28, dose 4MedDRA: Headache, Malaise, Medical counselling, Office visit, Rash — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Persistent headache for 8 days. A rash on my trunk, face and limbs for 4 days treated with antihistamines and prednisone 5 mg daily x 2 days. General malaise. · Healthcare visit (other): Appt with dermatologist and phone consult with rheumatologist.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-05
Report sent to call center — day 28, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-06-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-06-11
- 2022-06-18
- 2022-08-06
- 2022-11-05
- 2023-05-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-01 | Moderna | |
| 2 | 2021-01-29 | Moderna | |
| 3 | 2021-08-21 | Moderna | Flu |
| 4 | 2022-05-07 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Muscle soreness only after Pilates which disappeared after 10 minutes.
Release 8 — 3 months, dose 2
Symptoms: Severe muscle aches on quads and knees. Acute pain at tendon insertion points above knees. Knee joints extremely painful
Healthcare visit (other): Im person visits with my orthopedist. MRIs taken
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Glare of arthritis, possibly RA, unknown prior to immunizations . Began 2 months after initial dose
Release 11 — day 28, dose 4
Symptoms: Persistent headache for 8 days. A rash on my trunk, face and limbs for 4 days treated with antihistamines and prednisone 5 mg daily x 2 days. General malaise.
Healthcare visit (other): Appt with dermatologist and phone consult with rheumatologist.
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 | · | · | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Tendon pain | ✓ | ✓ | ✓ |
| SRO | Arthritis | · | · | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release