3M8-17593-66128
5 vaccinations
5 coded responses
53 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 806 / CO
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
- 2021-01-21
-
2021-01-22
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
-
2021-01-30
Survey response — day 7, dose 1MedDRA: Migraine — Feeling: Fair · HeadacheFree text: My usual once a month migraine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
- 2021-02-11
-
2021-02-18
Dose 2 — Moderna
- 2021-02-18
-
2021-02-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-03-04
-
2021-03-11
Survey response — day 21, dose 2MedDRA: Cough, Pre-existing disease, Respiratory tract congestion — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I have had coughing in the mornings due to allergies and asthma for some time, but I started having worsening coughing and chest congestion on Sunday this week. No fever.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-11
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-05-20
-
2021-08-19
Survey response — 6 months, dose 2MedDRA: Lymph node pain, Lymphadenopathy, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Enlarged lymph nodes in neck. Very painful on the right side. No tooth infection. Took Amoxicillin for ten days. Alleviated swelling gradually. ENT referred for physical therapy.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-19
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-20
-
2021-08-23
Call successfulParticipant prefers to complete VAERS report online
-
2021-10-30
Dose 3 — ModernaCo-administered: Flu:Shingles
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2021-12-11
-
2022-01-29
Survey response — 3 months, dose 3MedDRA: COVID-19, Chills, Cough, Emergency care, Fatigue, Nasal congestion — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Symptoms: I was diagnosed with COVID on Jan. 1, 2022. I had chills briefly, nasal congestion, fatigue, and a very sporadic cough. I had no breathing issues or fever. · Healthcare visit (other): The emergency room visit was only necessary because nothing else was open on New Year's Day and I had evacuees from the (b)(6) at my house.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-29
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
-
2022-02-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-25
Dose 4 — Moderna
- 2022-04-30
- 2022-05-15
- 2022-05-16
- 2022-05-23
- 2022-05-30
- 2022-06-06
- 2022-07-26
-
2022-09-21
Dose 5 — Pfizer-BioNTech
- 2022-10-03
- 2022-10-06
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-12-21
-
2023-03-22
Survey response — 6 months, dose 5MedDRA: Bronchitis, Physiotherapy — Feeling: FairMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-18 | Moderna | |
| 3 | 2021-10-30 | Moderna | Flu:Shingles |
| 4 | 2022-04-25 | Moderna | No |
| 5 | 2022-09-21 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
Free text
Release 3 — day 7, dose 1
Systemic reaction (other): My usual once a month migraine.
Release 5 — day 21, dose 2
Symptoms: I have had coughing in the mornings due to allergies and asthma for some time, but I started having worsening coughing and chest congestion on Sunday this week. No fever.
Release 9 — 6 months, dose 2
Symptoms: Enlarged lymph nodes in neck. Very painful on the right side. No tooth infection. Took Amoxicillin for ten days. Alleviated swelling gradually. ENT referred for physical therapy.
Release 11 — 3 months, dose 3
Symptoms: I was diagnosed with COVID on Jan. 1, 2022. I had chills briefly, nasal congestion, fatigue, and a very sporadic cough. I had no breathing issues or fever.
Healthcare visit (other): The emergency room visit was only necessary because nothing else was open on New Year's Day and I had evacuees from the (b)(6) at my house.
redacted (b)(6)
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 | Emergency care | · | · | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Lymph node pain | ✓ | · | ✓ |
| SD | Lymphadenopathy | ✓ | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Physiotherapy | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Migraine | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release