3HQ-85535-20631
2 vaccinations
5 coded responses
22 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 038 / NH
- Registered
- 2021-04-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-02
Dose 1 — Moderna
-
2021-04-03
Registered in v-safe
-
2021-04-03
Survey response — days 1–6 daily, dose 1MedDRA: Feeling cold, Nausea — Feeling: Good · Site: PainFree text: When outside, I feel the chill with the same outerwear I normally wear. Felt slightly nauseous early afternoon but only lasted 10 min or so.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
-
2021-04-05
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Headache — Feeling: Good · Site: PainFree text: Short period of time felt slight headache coming on, but it dissipated. Have had occasional feeling of chill a couple times yesterday and a very short period today, but it leaves very quickly - would not consider this under chills though.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-06
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Very slight soreness at injection site, nearly gone.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Survey response — days 1–6 daily, dose 1MedDRA: Pain — Feeling: GoodFree text: Any slight soreness about gone.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-08
- 2021-04-09
- 2021-04-16
- 2021-04-23
-
2021-04-30
Dose 2 — Moderna
-
2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-05-04
-
2021-05-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body achesAdult check-in
-
2021-05-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body achesAdult check-in
-
2021-05-07
Health check-in — day 7, dose 2Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-14
- 2021-05-21
-
2021-05-28
Survey response — day 28, dose 2MedDRA: Blood potassium decreased, Dehydration, Office visit, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: My last symptom since vaccine #2 to resolve itself has been aching legs, which recently intensified with a dehydration/lowered potassium episode. · Healthcare visit (other): And follow-up with PCPMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-28
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-04
- 2021-06-11
- 2021-08-02
- 2021-10-31
-
2022-02-14
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-02 | Moderna | |
| 2 | 2021-04-30 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): When outside, I feel the chill with the same outerwear I normally wear. Felt slightly nauseous early afternoon but only lasted 10 min or so.
Systemic reaction (other): Short period of time felt slight headache coming on, but it dissipated. Have had occasional feeling of chill a couple times yesterday and a very short period today, but it leaves very quickly - would not consider this under chills though.
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Very slight soreness at injection site, nearly gone.
Systemic reaction (other): Any slight soreness about gone.
Release 8 — day 28, dose 2
Symptoms: My last symptom since vaccine #2 to resolve itself has been aching legs, which recently intensified with a dehydration/lowered potassium episode.
Healthcare visit (other): And follow-up with PCP
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Blood potassium decreased | ✓ | ✓ | ✓ |
| SD | Dehydration | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Feeling cold | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release