4B9-21657-47226
4 vaccinations
7 coded responses
46 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 604 / IL
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Registered in v-safe
-
2021-01-29
Dose 1 — Moderna
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-12
- 2021-02-21
-
2021-02-26
Dose 2 — Moderna
- 2021-02-26
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite, Thirst — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: No appetite, very thirstyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · HeadacheAdult check-in
-
2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus — Feeling: GoodFree text: Generalized itching, not at the injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus — Feeling: Good · HeadacheFree text: General itching, not at the injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-12
- 2021-03-21
- 2021-03-27
- 2021-04-02
- 2021-04-10
-
2021-05-28
Survey response — 3 months, dose 2MedDRA: Headache, Office visit, Pain in jaw — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Pain in left temple, and left side of the head. Sometimes also in the jaw. · Healthcare visit (other): DentistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-28
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-27
-
2021-10-22
Dose 3 — Moderna
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-10-31
- 2021-11-05
- 2021-11-14
- 2021-11-21
- 2021-11-28
- 2021-12-05
- 2022-01-22
-
2022-04-15
Dose 4 — Moderna
- 2022-04-15
-
2022-04-17
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
-
2022-04-18
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-22
- 2022-04-29
- 2022-05-06
- 2022-05-13
-
2022-05-13
Call successfulParticipant prefers to complete VAERS report online
- 2022-05-21
-
2022-05-28
Survey response — day 42, dose 4MedDRA: Back pain, Musculoskeletal pain, Pain in extremity — Feeling: FairFree text: Sore arm/shoulder blade. Sore back.MedDRA releases: 2024-11 · check-in free text available
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2022-07-15
Survey response — 3 months, dose 4MedDRA: Office visit, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Physical Therapy for rotator cuff and bicep. · Healthcare visit (other): Office visit and physical therapy .MedDRA releases: 2024-11 · check-in free text available
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2022-07-15
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2022-07-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-10-14
Survey response — 6 months, dose 4MedDRA: Breast cancer, Breast conserving surgery — Feeling: Fair · Be unable to work or attend schoolFree text: I was diagnosed with breast cancer. I had a lumpectony and will start radiation soon.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-04-15 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): No appetite, very thirsty
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Generalized itching, not at the injection site.
Systemic reaction (other): General itching, not at the injection site.
Release 8 — 3 months, dose 2
Symptoms: Pain in left temple, and left side of the head. Sometimes also in the jaw.
Healthcare visit (other): Dentist
Release 11 — day 42, dose 4
Symptoms: Sore arm/shoulder blade. Sore back.
Release 12 — 3 months, dose 4
Symptoms: Physical Therapy for rotator cuff and bicep.
Healthcare visit (other): Office visit and physical therapy .
Release 12 — 6 months, dose 4
Symptoms: I was diagnosed with breast cancer. I had a lumpectony and will start radiation soon.
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 | Office visit | ✓ | ✓ | ✓ |
| HCVO | Physiotherapy | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Breast cancer | · | · | ✓ |
| SD | Breast conserving surgery | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Musculoskeletal pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pain in jaw | ✓ | ✓ | ✓ |
| SD | Physiotherapy | · | · | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Thirst | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release