3NF-23896-66432
5 vaccinations
6 coded responses
43 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 190 / PA
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-02-16
Dose 1 — Moderna
-
2021-03-16
Registered in v-safe
-
2021-03-16
Dose 2 — Moderna
- 2021-03-16
-
2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: Pyrexia — Feeling: Fair · Site: Pain · FeverFree text: Fever came down by noonMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
-
2021-03-19
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Pre-existing disease — Feeling: Good · Site: PainFree text: Very slight lower back pain. Probably unrelated since I do occasionally suffer bouts of back painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-21
- 2021-04-27
- 2021-06-15
- 2021-09-14
-
2021-10-28
Dose 3 — Moderna
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessAdult check-in
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-11
- 2022-01-27
-
2022-04-20
Dose 4 — Moderna
- 2022-04-28
-
2022-09-19
Dose 5 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-19
- 2022-09-21
- 2022-09-22
- 2022-09-23
-
2022-09-24
Survey response — days 1–6 daily, dose 5MedDRA: Headache — Feeling: GoodFree text: Slight headacheMedDRA releases: 2024-11 · check-in free text available
- 2022-09-25
- 2022-09-26
- 2022-10-03
- 2022-10-10
-
2022-10-17
Survey response — day 28, dose 5MedDRA: Nasopharyngitis — Feeling: FairFree text: I think I have come down with a mild cold. I was in contact last Thurs with someone who tested positive. I took a self test Friday and again Sunday but both tests were negative. So I am treating symptoms of a coldMedDRA releases: 2024-11 · check-in free text available
- 2022-10-26
-
2022-10-31
Survey response — day 42, dose 5MedDRA: Nasopharyngitis, Productive cough, SARS-CoV-2 test negative, Sinus congestion — Feeling: FairFree text: I have caught a head cold. Congestion of sinuses, phlegm, etc. COVID test was Negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-19
Survey response — 3 months, dose 5MedDRA: COVID-19, SARS-CoV-2 test negative, SARS-CoV-2 test positive — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I have COVID. I first tested positive in 12/4. I took 5 days of Paxlovid beginning 12/5. On 12/11 I felt better and tested negative. But by 12/15 symptoms returned.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-19
Report sent to call center — 3 months, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-12-20
- 2022-12-21
-
2022-12-21
Call successfulParticipant prefers to complete VAERS report online
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-16 | Moderna | |
| 2 | 2021-03-16 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
| 5 | 2022-09-19 | Pfizer-BioNTech | Flu |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Fever came down by noon
Systemic reaction (other): Very slight lower back pain. Probably unrelated since I do occasionally suffer bouts of back pain
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Slight headache
Release 12 — day 28, dose 5
Symptoms: I think I have come down with a mild cold. I was in contact last Thurs with someone who tested positive. I took a self test Friday and again Sunday but both tests were negative. So I am treating symptoms of a cold
Release 12 — day 42, dose 5
Symptoms: I have caught a head cold. Congestion of sinuses, phlegm, etc. COVID test was Negative.
Release 12 — 3 months, dose 5
Symptoms: I have COVID. I first tested positive in 12/4. I took 5 days of Paxlovid beginning 12/5. On 12/11 I felt better and tested negative. But by 12/15 symptoms returned.
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 | Nasopharyngitis | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | · | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release