42A-15612-52394
3 vaccinations
5 coded responses
26 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 300 / GA
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Moderna
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-28
- 2021-02-04
-
2021-02-11
Dose 2 — Moderna
-
2021-02-11
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: Fair · Headache, Fatigue or tiredness, NauseaFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Joint pains, Fatigue or tirednessAdult check-in
- 2021-02-16
-
2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness, NauseaAdult check-in
-
2021-02-18
Health check-in — day 7, dose 2Feeling: Fair · Headache, Joint pains, Fatigue or tirednessAdult check-in
-
2021-02-25
Survey response — day 14, dose 2MedDRA: Chills — Feeling: FairFree text: Bad chills last night for awhileMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-27
- 2021-05-18
-
2021-08-12
Survey response — 6 months, dose 2MedDRA: SARS-CoV-2 test positive — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Tested positive for covid on August 6,2021MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-12
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-19
-
2021-08-23
Call successfulParticipant prefers to complete VAERS report online
-
2021-11-09
Dose 3 — Moderna
-
2022-02-11
Survey response — 12 months, dose 2MedDRA: COVID-19, Fatigue, Headache, Pain, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activitiesFree text: Tested positive for Covid in August 2021 It was sars Covid mild case I had severe headache severe fatigue and some achy feelings but that wasn't bad ,symptoms lasted about 5 days.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-15
-
2022-11-09
Survey response — 12 months, dose 3MedDRA: Eye pain, Injection site swelling, Injection site warmth, Lacrimation increased, Ocular hyperaemia — Feeling: Good · Be unable to do your normal daily activitiesFree text: After my last Covid shot later that day my arm swelled at site of injection and was hot to the touch but I did not run a fever. My eyes became very very red and hurt a lot watered a lot too. The next day it was much better. I also got a flu shotMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): No
Release 4 — day 14, dose 2
Symptoms: Bad chills last night for awhile
Release 9 — 6 months, dose 2
Symptoms: Tested positive for covid on August 6,2021
Release 11 — 12 months, dose 2
Symptoms: Tested positive for Covid in August 2021 It was sars Covid mild case I had severe headache severe fatigue and some achy feelings but that wasn't bad ,symptoms lasted about 5 days.
Release 12 — 12 months, dose 3
Symptoms: After my last Covid shot later that day my arm swelled at site of injection and was hot to the touch but I did not run a fever. My eyes became very very red and hurt a lot watered a lot too. The next day it was much better. I also got a flu shot
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 | Chills | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Eye pain | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site swelling | · | · | ✓ |
| SD | Injection site warmth | · | · | ✓ |
| SD | Lacrimation increased | · | · | ✓ |
| SD | Ocular hyperaemia | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | SARS-CoV-2 test positive | ✓ | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release