3YS-26693-65978
2 vaccinations
13 coded responses
18 check-ins
13 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 959 / CA
- Registered
- 2021-01-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2020-12-28
Dose 1 — Moderna
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2021-01-24
Registered in v-safe
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2021-01-24
Survey response — day 21, dose 1MedDRA: Abdominal pain upper, Decreased appetite, Insomnia — Feeling: FairFree text: Bad stomachache. Lackbof appetite SleeplessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-25
Survey response — day 28, dose 1MedDRA: Abdominal pain upper, Decreased appetite, Nausea — Feeling: Good · Be unable to workFree text: Bad stomachache , lack of appetite and nauseaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-28
Dose 2 — Moderna
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2021-01-28
Survey response — day 0, dose 2MedDRA: Dizziness, Feeling abnormal — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Nausea, Abdominal pain · Be unable to workFree text: Weird head and neck feeling. Like they are not connected . Dizzy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-29
Survey response — days 1–6 daily, dose 2MedDRA: Pain — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: Shooting pain. Randomly. Sometime in my head and in my liverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-30
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite, Dizziness — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Lack of appetite. LightheadedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-31
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-02-01
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate increased — Feeling: Fair · Site: Itching · Fatigue or tiredness, NauseaFree text: Occasional rapid heart rateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-02
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate increased — Feeling: Fair · Site: Itching · Headache, Fatigue or tirednessFree text: Heart rate soeeds up occasionallyMedDRA 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: Fair · Site: Itching · Headache, NauseaAdult check-in
- 2021-02-04
- 2021-02-11
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2021-02-18
Survey response — day 21, dose 2MedDRA: Abdominal pain upper, Back pain — Feeling: FairFree text: Return of stomachache and liw back acheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-25
Survey response — day 28, dose 2MedDRA: Headache, Musculoskeletal discomfort, Pain assessment — Feeling: GoodFree text: Return of headache and low back discomfort. Pain scale 4/10MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Survey response — day 35, dose 2MedDRA: Headache, Pain in extremity, Self-medication — Feeling: GoodFree text: One time last week i had 7/10 bilateral leg pain. Required me to take Aleve to aleviate it. Also a couple if headaches last week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Survey response — day 42, dose 2MedDRA: Dizziness, Self-medication — Feeling: FairFree text: Today i have had the weird dizzy head feeling that i had initially with the 2nd dose.Just took Aleve to see if it helps.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
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2021-07-29
Survey response — 6 months, dose 2MedDRA: Bone pain, Headache, Herpes zoster — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Shingles x2 Headaches Bone painMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-07-29
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-09
- 2021-08-12
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2021-08-16
Call successfulParticipant prefers to complete VAERS report online
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2022-01-28
Survey response — 12 months, dose 2MedDRA: Immunisation reaction, Malaise, Meningitis, Rash, West Nile viral infection — 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 · Emergency room or emergency department visit, HospitalizationFree text: Booster shot reactions. Skin rashes and malaise Contracted West Nile virus and subsequently meningitisMedDRA releases: 2024-11 · check-in free text available
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2022-01-28
Report sent to call center — 12 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 prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
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2022-02-01
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-28 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 2 — day 21, dose 1
Symptoms: Bad stomachache. Lackbof appetite Sleepless
Release 2 — day 28, dose 1
Symptoms: Bad stomachache , lack of appetite and nausea
Release 3 — day 0, dose 2
Systemic reaction (other): Weird head and neck feeling. Like they are not connected . Dizzy.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Shooting pain. Randomly. Sometime in my head and in my liver
Systemic reaction (other): Lack of appetite. Lightheaded
Systemic reaction (other): Occasional rapid heart rate
Systemic reaction (other): Heart rate soeeds up occasionally
Release 4 — day 21, dose 2
Symptoms: Return of stomachache and liw back ache
Release 4 — day 28, dose 2
Symptoms: Return of headache and low back discomfort. Pain scale 4/10
Release 5 — day 35, dose 2
Symptoms: One time last week i had 7/10 bilateral leg pain. Required me to take Aleve to aleviate it. Also a couple if headaches last week.
Release 5 — day 42, dose 2
Symptoms: Today i have had the weird dizzy head feeling that i had initially with the 2nd dose.Just took Aleve to see if it helps.
Release 9 — 6 months, dose 2
Symptoms: Shingles x2 Headaches Bone pain
Release 11 — 12 months, dose 2
Symptoms: Booster shot reactions. Skin rashes and malaise Contracted West Nile virus and subsequently meningitis
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Bone pain | ✓ | · | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Herpes zoster | ✓ | · | ✓ |
| SD | Immunisation reaction | · | · | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Meningitis | · | · | ✓ |
| SD | Musculoskeletal discomfort | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pain assessment | ○ | ✓ | ○ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | West Nile viral infection | · | · | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release