3L2-18080-63682
3 vaccinations
10 coded responses
38 check-ins
10 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 125 / NY
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Registered in v-safe
-
2021-01-11
Dose 1 — Moderna
- 2021-01-11
-
2021-01-12
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-13
Survey response — days 1–6 daily, dose 1MedDRA: Anxiety — Feeling: FairFree text: No except anxiety over the state of countryMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-14
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Bone pain, Lymphadenopathy, Neck pain, Office visit — Feeling: Fair · Site: Pain, Itching · Muscle or body aches · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Went to urgent care due to shoulder, neck pain and very painful spot I skull near left ear, likely swollen lymph node. MD could be result of amped up immune system associated with vaccine. She said it means vaccine is working . Prescribed low dies muscle relaxant if needed but I likely wont take it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-14
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-15
Survey response — days 1–6 daily, dose 1MedDRA: Lymph gland infection — Feeling: Good · Muscle or body achesFree text: Still have infected lymph node occipitalMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: GoodFree text: Same occipital mode painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-18
- 2021-01-25
- 2021-02-01
-
2021-02-08
Dose 2 — Moderna
- 2021-02-08
- 2021-02-10
- 2021-02-11
-
2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Mass, Pain — Feeling: FairFree text: Lump behind earpainfulMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-22
- 2021-03-03
- 2021-03-08
-
2021-03-09
Callback requested for3:00P EST
-
2021-03-09
Call successfulCompleted over the phone
- 2021-03-15
- 2021-03-23
- 2021-05-12
- 2021-08-09
-
2021-10-25
Dose 3 — Moderna
- 2021-10-26
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: Pain, SwellingFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
- 2021-10-29
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-24
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2021-11-29
Survey response — day 35, dose 3MedDRA: Asthenopia, Eye irritation, Fatigue, Headache, Influenza like illness — Feeling: FairFree text: Flu like symptoms- headache (mild) fatigue , irritated or tired eyesMedDRA releases: 2024-11 · check-in free text available
- 2021-12-06
- 2022-01-24
- 2022-04-25
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2022-10-25
Survey response — 12 months, dose 3MedDRA: Office visit, Renal cyst — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Renal cyst to be removed · Healthcare visit (other): Office visits radiologyMedDRA releases: 2024-11 · check-in free text available
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2022-10-25
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
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2022-10-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Call center
2 call center cases
2 successful
VAERS report filed, before or during a call: 1
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): No
Systemic reaction (other): No except anxiety over the state of country
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Went to urgent care due to shoulder, neck pain and very painful spot I skull near left ear, likely swollen lymph node. MD could be result of amped up immune system associated with vaccine. She said it means vaccine is working . Prescribed low dies muscle relaxant if needed but I likely wont take it.
Systemic reaction (other): Still have infected lymph node occipital
Systemic reaction (other): Same occipital mode pain
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Lump behind earpainful
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): No
Systemic reaction (other): No
Release 10 — day 35, dose 3
Symptoms: Flu like symptoms- headache (mild) fatigue , irritated or tired eyes
Release 12 — 12 months, dose 3
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 | Asthenopia | · | · | ✓ |
| SD | Eye irritation | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Renal cyst | · | · | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Bone pain | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Lymph gland infection | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Mass | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Office visit | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ○ | ○ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release