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48C-21180-95845

5 vaccinations 5 coded responses 16 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
106 / NY
Registered
2021-04-22
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-21
    Dose 1 — Moderna
  2. 2021-04-20
    Dose 2 — Moderna
  3. 2021-04-22
    Registered in v-safe
  4. 2021-04-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue, Headache, Injection site erythema, Injection site pain, Injection site swelling, Nausea — Feeling: Good · Site: Pain, Redness, Swelling
    Free text: Had slight headache and gen. Tirednessx2days from the vaccination day, today felt better just noticed slight redness and swelling and mild pain on the injection site this am
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  6. 2021-04-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site erythema — Feeling: Good · Rash, not including the immediate area around the injection site
    Free text: Not rash,mild redness 6 inches from the injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site erythema — Feeling: Good
    Free text: Slight redness 6 inches from injection site , almost gone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-04-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-04-27
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-05-04
    Survey response — day 14, dose 2
    MedDRA: Erythema — Feeling: Good
    Free text: Noticed red spots on the inner aspect of the left thigh 3 inches from groin area. Not itchy, not rash, no swelling,noted this am
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-05-11
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-07-20
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-10-19
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-11-02
    Dose 3 — Pfizer-BioNTech
  15. 2022-03-30
    Dose 4 — Moderna
  16. 2022-04-20
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  17. 2022-05-01
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  18. 2022-05-04
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  19. 2022-05-11
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  20. 2022-06-29
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  21. 2022-09-26
    Dose 5 — Moderna
  22. 2023-03-30
    Survey response — 12 months, dose 4
    MedDRA: Ageusia, Hyposmia, Nasopharyngitis — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    MedDRA releases: 2024-11
  23. 2023-03-30
    Report sent to call center — 12 months, dose 4
    Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  24. 2023-03-31
  25. 2023-04-04
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-03-21Moderna
22021-04-20Moderna
32021-11-02Pfizer-BioNTech No
42022-03-30Moderna No
52022-09-26Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Had slight headache and gen. Tirednessx2days from the vaccination day, today felt better just noticed slight redness and swelling and mild pain on the injection site this am

2021-04-24

Systemic reaction (other): Not rash,mild redness 6 inches from the injection site

2021-04-25

Systemic reaction (other): Slight redness 6 inches from injection site , almost gone

Release 8 — day 14, dose 2

2021-05-04

Symptoms: Noticed red spots on the inner aspect of the left thigh 3 inches from groin area. Not itchy, not rash, no swelling,noted this am

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

FieldPreferred term2021-092023-042024-11
SDAgeusia · · ✓
SDErythema ✓ ✓ ✓
SDHyposmia · · ✓
SDNasopharyngitis · · ✓
SROFatigue ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SRONausea ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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