3ML-30552-95640
3 vaccinations
9 coded responses
38 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 500 / IA
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Registered dependents
Z4B-33312-69723
Child or adolescent in my care · Male · 2021-11-11
NM8-26716-18862
Child or adolescent in my care · Female · 2021-11-11
Timeline
-
2021-01-05
Dose 1 — Moderna
-
2021-01-06
Registered in v-safe
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-19
- 2021-01-26
-
2021-02-02
Dose 2 — Moderna
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2021-02-02
Survey response — day 0, dose 2MedDRA: Hypertension — Feeling: GoodFree text: High blood pressureMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite — Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: No appetiteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-05
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Oedema peripheral — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: Armpit swollen & painfulMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: Good · Joint painsFree text: Armpit hurtsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-05-04
- 2021-08-03
-
2021-11-11
Dose 3 — Moderna
- 2021-11-11
-
2021-11-12
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Armpit swollen and hurtsMedDRA releases: 2024-11 · check-in free text available
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2021-11-13
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Armpit hurts and swollenMedDRA releases: 2024-11 · check-in free text available
-
2021-11-14
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Fatigue or tirednessAdult check-in
- 2021-11-16
-
2021-11-18
Survey response — day 7, dose 3MedDRA: Muscle spasms, Sleep disorder — Feeling: GoodFree text: Muscle spasm in left leg/ankle three times last night while sleepingMedDRA releases: 2024-11 · check-in free text available
- 2021-11-25
- 2021-12-03
- 2021-12-09
- 2021-12-18
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2021-12-23
Survey response — day 42, dose 3MedDRA: Sinus disorder — Feeling: FairFree text: Sinus issues since ThanksgivingMedDRA releases: 2024-11 · check-in free text available
- 2022-02-10
- 2022-05-12
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2022-11-11
Survey response — 12 months, dose 3MedDRA: COVID-19, Pneumonia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Got COVID 8-16-22 then pneumonia on 10-25-22.MedDRA releases: 2024-11 · check-in free text available
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2022-11-11
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-02 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-11 | Unsuccessful |
Free text
Release 3 — day 0, dose 2
Systemic reaction (other): High blood pressure
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): No appetite
Systemic reaction (other): Armpit swollen & painful
Systemic reaction (other): Armpit hurts
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Armpit swollen and hurts
Systemic reaction (other): Armpit hurts and swollen
Release 10 — day 7, dose 3
Systemic reaction (other): Muscle spasm in left leg/ankle three times last night while sleeping
Release 10 — day 42, dose 3
Symptoms: Sinus issues since Thanksgiving
Release 12 — 12 months, dose 3
Symptoms: Got COVID 8-16-22 then pneumonia on 10-25-22.
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 |
|---|---|---|---|---|
| SD | COVID-19 | · | · | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Sinus disorder | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Hypertension | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | · | · | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release