4AW-65500-91984
5 vaccinations
8 coded responses
52 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 223 / VA
- Registered
- 2021-03-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-22
Dose 1 — Moderna
-
2021-03-28
Registered in v-safe
- 2021-03-28
- 2021-03-29
- 2021-04-05
- 2021-04-12
-
2021-04-19
Dose 2 — Moderna
- 2021-04-19
-
2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Pain, Paraesthesia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: Shooting, twinging pain in left hip, both internal and pain on front and back left hip, hands tingling at times.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-21
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Good · HeadacheFree text: Mild headache in morning then went away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Rash, Rash pruritic — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Mild rash that itches on upper right chest, near collar boneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
- 2021-04-25
- 2021-04-26
- 2021-05-03
-
2021-05-10
Survey response — day 21, dose 2MedDRA: Back pain, Migraine, Myalgia, Neck pain, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesFree text: From Saturday through Sunday had a migraine, and then tight, sore painful back/neck muscles in left shoulder and left neck area. Not sure if this is connected to vaccine. I normally get migraines.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-17
- 2021-05-24
- 2021-05-31
- 2021-07-19
- 2021-10-18
-
2021-11-15
Dose 3 — Moderna
-
2021-11-17
Survey response — days 1–6 daily, dose 3MedDRA: Adverse reaction, Feeling abnormal — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Systemic reaction (other): These symptoms occurred on 11/16, one day after my booster shot. Symptoms were mild during day, but were severe in evening. · Healthcare visit (other): Stayed at work during day, felt worse in evening.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-17
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-11-18
-
2021-11-18
Call successfulParticipant prefers to complete VAERS report online
- 2021-11-19
- 2021-11-20
- 2021-11-21
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-13
- 2021-12-20
- 2021-12-27
- 2022-02-14
-
2022-05-13
Dose 4 — Moderna
- 2022-05-16
-
2022-05-19
Survey response — days 1–6 daily, dose 4MedDRA: Chills, Fatigue, Headache, Pain — Feeling: Good · Site: PainFree text: 6 hours after receiving shot, had chills, headache, body aches, fatigue for 24 hrs.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-20
Survey response — day 7, dose 4MedDRA: Epistaxis — Feeling: GoodFree text: Bloody nose for 15 minMedDRA releases: 2024-11 · check-in free text available
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-08-12
- 2022-11-11
-
2022-12-07
Dose 5 — Moderna
-
2022-12-09
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-12-10
- 2022-12-12
- 2022-12-13
-
2022-12-14
Survey response — day 7, dose 5MedDRA: Migraine — Feeling: Good · HeadacheFree text: Took meds for migraineMedDRA releases: 2024-11 · check-in free text available
- 2022-12-21
- 2022-12-28
- 2023-01-04
- 2023-01-11
- 2023-01-18
- 2023-03-08
- 2023-06-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-22 | Moderna | |
| 2 | 2021-04-19 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-05-13 | Moderna | No |
| 5 | 2022-12-07 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Shooting, twinging pain in left hip, both internal and pain on front and back left hip, hands tingling at times.
Systemic reaction (other): Mild headache in morning then went away.
Systemic reaction (other): Mild rash that itches on upper right chest, near collar bone
Release 8 — day 21, dose 2
Symptoms: From Saturday through Sunday had a migraine, and then tight, sore painful back/neck muscles in left shoulder and left neck area. Not sure if this is connected to vaccine. I normally get migraines.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): These symptoms occurred on 11/16, one day after my booster shot. Symptoms were mild during day, but were severe in evening.
Healthcare visit (other): Stayed at work during day, felt worse in evening.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): 6 hours after receiving shot, had chills, headache, body aches, fatigue for 24 hrs.
Release 11 — day 7, dose 4
Systemic reaction (other): Bloody nose for 15 min
Release 12 — day 7, dose 5
Systemic reaction (other): Took meds for migraine
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 |
|---|---|---|---|---|
| HCVO | Feeling abnormal | · | · | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Migraine | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Epistaxis | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Migraine | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release