4CE-33105-65047
4 vaccinations
3 coded responses
29 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 802 / CO
- Registered
- 2021-04-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-04-01
Dose 1 — Moderna
-
2021-04-10
Registered in v-safe
-
2021-04-10
Health check-in — day 7, dose 1Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-04-15
-
2021-04-29
Dose 2 — Moderna
- 2021-04-29
-
2021-04-30
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Joint pains, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-05-03
Survey response — days 1–6 daily, dose 2MedDRA: Tinnitus — Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Ringing in right earMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-05-07
- 2021-05-13
- 2021-05-20
- 2021-05-29
-
2021-06-03
Survey response — day 35, dose 2MedDRA: Anaemia, Fatigue, Office visit — Feeling: Fair · Be unable to work, 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: Symptoms: Extreme physical and mental exhaustion. Diagnosis of anemia. · Healthcare visit (other): Office visitsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-03
Report sent to call center — day 35, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-12
-
2021-10-30
Dose 3 — Moderna
- 2021-10-30
- 2021-10-30
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tirednessAdult check-in
-
2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · HeadacheAdult check-in
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · HeadacheAdult check-in
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · HeadacheAdult check-in
-
2021-11-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Swelling, Itching · Headache, Fatigue or tirednessAdult check-in
-
2021-11-06
Health check-in — day 7, dose 3Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tirednessAdult check-in
- 2021-11-13
- 2021-12-13
-
2022-01-20
Call successfulParticipant prefers to complete VAERS report online
- 2022-05-02
-
2022-09-12
Dose 4 — Pfizer-BioNTech
- 2022-09-28
- 2022-10-24
-
2022-12-12
Survey response — 3 months, dose 4MedDRA: Nasal congestion, Sinus headache — Feeling: Fair · Be unable to work or attend schoolFree text: Severe nasal congestion, sinus headaches.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-04-29 | Moderna | |
| 3 | 2021-10-30 | Moderna | No |
| 4 | 2022-09-12 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-03 | Successful 2022-01-20 |
Participant prefers to complete VAERS report online |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Ringing in right ear
Release 8 — day 35, dose 2
Symptoms: Extreme physical and mental exhaustion. Diagnosis of anemia.
Healthcare visit (other): Office visits
Release 12 — 3 months, dose 4
Symptoms: Severe nasal congestion, sinus headaches.
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 | ✓ | ✓ | ✓ |
| SD | Anaemia | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Sinus headache | · | · | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release