447-39481-62541
5 vaccinations
3 coded responses
46 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 836 / ID
- Registered
- 2021-02-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-14
Dose 1 — Moderna
-
2021-02-15
Registered in v-safe
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-21
- 2021-02-28
- 2021-03-07
-
2021-03-14
Dose 2 — Moderna
- 2021-03-14
-
2021-03-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-28
- 2021-04-04
- 2021-04-11
- 2021-04-19
- 2021-04-25
- 2021-06-13
- 2021-09-12
-
2021-10-23
Dose 3 — Moderna
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Itching · Fatigue or tirednessAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2022-01-22
-
2022-04-23
Survey response — 6 months, dose 3MedDRA: Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Tinnitus actually since October, 2021 but forgot to report it beforeMedDRA releases: 2024-11 · check-in free text available
-
2022-04-23
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-26
Call successfulParticipant prefers to complete VAERS report online
-
2022-04-27
Dose 4 — Moderna
- 2022-05-15
-
2022-05-20
Survey response — day 21, dose 4MedDRA: Blepharitis, Pre-existing disease, Pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Scalp Lichen Planopilaris has gotten itchier as has Blepharitis. Note I have had the former condition since 2015, but the latter condition started in fall of 2021.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-20
Report sent to call center — day 21, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-23
- 2022-05-23
- 2022-05-27
- 2022-06-02
-
2022-06-10
Survey response — day 42, dose 4MedDRA: Blepharitis, Discomfort, Eustachian tube dysfunction, Ocular rosacea, Office visit, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Since 1st booster I have accumulated a combination of tinnitus, eustatchian tube dysfunction, blepharitis and, most recently after 2nd booster, ocular rosacea. Not sure if these are vaccine related, but quite uncomfortable. Have seen ENT and Eye DocsMedDRA releases: 2024-11 · check-in free text available
-
2022-06-10
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-06-13
- 2022-06-13
- 2022-07-27
-
2022-09-30
Dose 5 — Pfizer-BioNTech
- 2022-10-26
- 2022-10-26
- 2022-10-28
- 2022-11-04
- 2022-11-13
- 2022-12-30
- 2023-04-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-14 | Moderna | |
| 2 | 2021-03-14 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-27 | Moderna | No |
| 5 | 2022-09-30 | Pfizer-BioNTech | No |
Call center
3 call center cases
1 successful · 2 unsuccessful
Free text
Release 11 — 6 months, dose 3
Symptoms: Tinnitus actually since October, 2021 but forgot to report it before
Release 11 — day 21, dose 4
Symptoms: Scalp Lichen Planopilaris has gotten itchier as has Blepharitis. Note I have had the former condition since 2015, but the latter condition started in fall of 2021.
Release 12 — day 42, dose 4
Symptoms: Since 1st booster I have accumulated a combination of tinnitus, eustatchian tube dysfunction, blepharitis and, most recently after 2nd booster, ocular rosacea. Not sure if these are vaccine related, but quite uncomfortable. Have seen ENT and Eye Docs cut off by CDC
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 | Blepharitis | · | · | ✓ |
| SD | Discomfort | · | · | ✓ |
| SD | Eustachian tube dysfunction | · | · | ✓ |
| SD | Ocular rosacea | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release