4LV-95111-87110
2 vaccinations
3 coded responses
25 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 294 / SC
- Registered
- 2021-03-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-08
Registered in v-safe
-
2021-03-08
Dose 1 — Moderna
- 2021-03-08
-
2021-03-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tirednessAdult check-in
-
2021-03-10
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
-
2021-03-22
Survey response — day 14, dose 1MedDRA: Immunisation reaction, Medical counselling, Nodule, Pruritus, Pyrexia, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Last Tuesday night the site began to itch and only got worse the next day. Also had a knot again and it was running fever. Went to school and asked nurse, she said it wasCOVID arm and to take some Benadryl and some aspirin when I got home. · Healthcare visit (other): School nurseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-22
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-29
-
2021-04-05
Dose 2 — Moderna
- 2021-04-05
-
2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body achesAdult check-in
-
2021-04-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-08
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-20
- 2021-04-26
- 2021-05-03
-
2021-05-10
Survey response — day 35, dose 2MedDRA: Chills, Diarrhoea, Dizziness, Fatigue, Headache, Nausea, Oropharyngeal pain — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I have had a headache for 5 days, chills, sore throat, diarrhia, dizziness, nausea, and fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-10
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)
- 2021-05-18
- 2021-06-01
- 2021-07-05
- 2021-10-04
- 2021-12-01
- 2021-12-01
-
2021-12-03
Call successfulParticipant prefers to complete VAERS report online
-
2022-04-05
Survey response — 12 months, dose 2MedDRA: Adverse reaction, COVID-19, Office visit — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I received my booster vaccination on Friday, January 7 and had symptoms by Sunday January 9 and was diagnosed with Covid by Wednesday January 12. · Healthcare visit (other): Dr officeMedDRA releases: 2024-11 · check-in free text available
-
2022-04-05
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2022-04-12
- 2022-04-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-08 | Moderna | |
| 2 | 2021-04-05 | Moderna |
Call center
3 call center cases
2 successful · 1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 6 — day 14, dose 1
Symptoms: Last Tuesday night the site began to itch and only got worse the next day. Also had a knot again and it was running fever. Went to school and asked nurse, she said it wasCOVID arm and to take some Benadryl and some aspirin when I got home.
Healthcare visit (other): School nurse
Release 8 — day 35, dose 2
Symptoms: I have had a headache for 5 days, chills, sore throat, diarrhia, dizziness, nausea, and fatigue
Release 11 — 12 months, dose 2
Symptoms: I received my booster vaccination on Friday, January 7 and had symptoms by Sunday January 9 and was diagnosed with Covid by Wednesday January 12.
Healthcare visit (other): Dr office
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 | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Adverse reaction | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Nodule | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release