4LD-30409-04414
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 544 / WI
- Registered
- 2021-02-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-16
Registered in v-safe
-
2021-02-16
Dose 1 — Moderna
- 2021-02-16
- 2021-02-17
-
2021-02-18
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Arthritis, Pre-existing disease — Feeling: Good · Joint painsFree text: I have arthritis so pain probably from thatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
- 2021-03-09
-
2021-03-16
Dose 2 — Moderna
- 2021-03-16
-
2021-03-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-22
- 2021-03-23
- 2021-03-30
- 2021-04-06
-
2021-04-13
Survey response — day 28, dose 2MedDRA: Cough, Hypersensitivity, Pre-existing disease, Sinus operation — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: My allergies are bad. Even though on meds lots of coughing and drainage. Better in am and worse later in day. Pollen count is high now. I have a prescheduled doctor's appt tomorrow so will talk to him about it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-13
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-20
-
2021-04-27
Survey response — day 42, dose 2MedDRA: Abdominal pain upper, Cough, Nasal congestion, Office visit, Oropharyngeal pain, Paranasal sinus hypersecretion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: I had sore throat and nasal fluid. Took strep testbut negative. Pollen count very high though. Better now but had belly pain last 4 days. That is gradually getting better but think I ate some bad gas station food. · Healthcare visit (other): I already had a doctor appt so asked for strep test.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-27
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-15
-
2021-09-14
Survey response — 6 months, dose 2MedDRA: Hypertension — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: High blood pressure diagnosedMedDRA releases: 2024-11 · check-in free text available
-
2021-09-14
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-15
Call successfulCompleted over the phone
-
2022-03-16
Survey response — 12 months, dose 2MedDRA: Hypertension — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: High blood pressureMedDRA releases: 2024-11 · check-in free text available
-
2022-03-16
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-16 | Moderna | |
| 2 | 2021-03-16 | Moderna |
Call center
4 call center cases
4 successful
VAERS report filed, before or during a call: 3
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): I have arthritis so pain probably from that
Release 7 — day 28, dose 2
Symptoms: My allergies are bad. Even though on meds lots of coughing and drainage. Better in am and worse later in day. Pollen count is high now. I have a prescheduled doctor's appt tomorrow so will talk to him about it.
Release 8 — day 42, dose 2
Symptoms: I had sore throat and nasal fluid. Took strep testbut negative. Pollen count very high though. Better now but had belly pain last 4 days. That is gradually getting better but think I ate some bad gas station food.
Healthcare visit (other): I already had a doctor appt so asked for strep test.
Release 9 — 6 months, dose 2
Symptoms: High blood pressure diagnosed
Release 11 — 12 months, dose 2
Symptoms: High blood pressure
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Paranasal sinus hypersecretion | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Sinus operation | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Arthritis | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release