3LJ-95379-57645
3 vaccinations
6 coded responses
40 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 383 / TN
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-29
Dose 1 — Moderna
-
2020-12-30
Registered in v-safe
-
2020-12-30
Survey response — days 1–6 daily, dose 1MedDRA: Eczema, Pre-existing disease, Stress — Feeling: Good · Site: PainFree text: Eczema area has reddened and raised. Could be attributed to stress as well.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2020-12-31
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Chills, Fatigue or tiredness, NauseaFree text: Could be the weather. Also dealing with my Dad's loss to Covid. Also I have 2 patients dx with Covid. One is DNR.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-12
- 2021-01-19
-
2021-01-26
Dose 2 — Moderna
-
2021-01-26
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-01-27
Survey response — days 1–6 daily, dose 2MedDRA: Dysgeusia, Eczema, Erythema, Rash — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activitiesFree text: Metallic taste since 1-26. Rash is my eczema area on forehead and redness in both check areas. I documented every thing I was going thru since 3pm yesterday, day of dosage givenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-28
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Lower back pain started last night. Its a constant pain. Feels like labor pain. Have taken Tylenol .MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-04-27
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2021-07-27
Survey response — 6 months, dose 2MedDRA: Exposure to SARS-CoV-2, General symptom, Office visit, SARS-CoV-2 test — 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 professionalFree text: Symptoms: Unknowingly fully exposed to pos case on 7-10-21. Drive to Virginia for vacation. Friend had pos test on 7-13-21. Left VA on 7-14-21. Had both tests on 7-15-21. Even though Im vaccinated, it hit me fast. I was showing symptoms on 7-14-21. · Healthcare visit (other): PCP office express careMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-07-27
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-08-04
-
2021-08-04
Call successfulParticipant prefers to complete VAERS report online
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2021-12-08
Dose 3 — Moderna
- 2021-12-08
-
2021-12-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body achesAdult check-in
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2021-12-10
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body achesAdult check-in
- 2021-12-11
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-15
-
2021-12-22
Survey response — day 14, dose 3MedDRA: Injection site reaction — Feeling: GoodFree text: Basically, the arm of the injection site- muscular area is bothersomenot would I consider painMedDRA releases: 2024-11 · check-in free text available
- 2021-12-29
- 2022-01-05
- 2022-01-12
- 2022-01-19
- 2022-03-09
- 2022-06-08
- 2022-12-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-29 | Moderna | |
| 2 | 2021-01-26 | Moderna | |
| 3 | 2021-12-08 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Eczema area has reddened and raised. Could be attributed to stress as well.
Systemic reaction (other): Could be the weather. Also dealing with my Dad's loss to Covid. Also I have 2 patients dx with Covid. One is DNR.
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Metallic taste since 1-26. Rash is my eczema area on forehead and redness in both check areas. I documented every thing I was going thru since 3pm yesterday, day of dosage given
Systemic reaction (other): Lower back pain started last night. Its a constant pain. Feels like labor pain. Have taken Tylenol .
Release 9 — 6 months, dose 2
Symptoms: Unknowingly fully exposed to pos case on 7-10-21. Drive to Virginia for vacation. Friend had pos test on 7-13-21. Left VA on 7-14-21. Had both tests on 7-15-21. Even though Im vaccinated, it hit me fast. I was showing symptoms on 7-14-21.
Healthcare visit (other): PCP office express care
Release 10 — day 14, dose 3
Symptoms: Basically, the arm of the injection site- muscular area is bothersomenot would I consider pain
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 | Exposure to SARS-CoV-2 | ✓ | · | ✓ |
| SD | General symptom | ✓ | · | ✓ |
| SD | Injection site reaction | · | · | ✓ |
| SD | SARS-CoV-2 test | ✓ | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Eczema | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Stress | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release