4T4-25289-43553
2 vaccinations
4 coded responses
22 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 104 / NY
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Registered in v-safe
-
2021-01-28
Dose 1 — Moderna
- 2021-01-28
-
2021-01-29
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-05
- 2021-02-11
- 2021-02-20
-
2021-02-25
Dose 2 — Moderna
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Limb immobilisation, Pain, Pyrexia — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: One day after receiving vaccine unable to move my arm, felt feverish fatiged and had aches allover my bodyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Loss of personal independence in daily activities — Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessFree text: My post vaccine symptoms have slowed down my ability to perform my normal daily activities friday was post vaccination day #1 and it was the worst. Since then I have been improving and severity of symptoms decreasing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-03
- 2021-03-04
- 2021-03-11
-
2021-03-18
Survey response — day 21, dose 2MedDRA: Asthma prophylaxis, Chronic obstructive pulmonary disease, Epistaxis, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Exacerbation of asthma and copd. Episode of epistaxis.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-18
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-05-27
-
2021-08-26
Survey response — 6 months, dose 2MedDRA: Arthralgia, Joint swelling, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Im having severe swelling and pain to my left knee. Im seeing an Orthopedist to find a diagnosis. · Healthcare visit (other): Appointment with OrthopedistMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-26
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-27
Call successfulParticipant prefers to complete VAERS report online
-
2021-08-27
Call successfulParticipant prefers to complete VAERS report online
- 2022-02-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-25 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): One day after receiving vaccine unable to move my arm, felt feverish fatiged and had aches allover my body
Systemic reaction (other): My post vaccine symptoms have slowed down my ability to perform my normal daily activities friday was post vaccination day #1 and it was the worst. Since then I have been improving and severity of symptoms decreasing.
Release 5 — day 21, dose 2
Symptoms: Exacerbation of asthma and copd. Episode of epistaxis.
Release 9 — 6 months, dose 2
Symptoms: Im having severe swelling and pain to my left knee. Im seeing an Orthopedist to find a diagnosis.
Healthcare visit (other): Appointment with Orthopedist
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 | Arthralgia | ✓ | · | ✓ |
| SD | Asthma prophylaxis | ✓ | ✓ | ✓ |
| SD | Chronic obstructive pulmonary disease | ✓ | ✓ | ✓ |
| SD | Epistaxis | ✓ | ✓ | ✓ |
| SD | Joint swelling | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Limb immobilisation | ✓ | ✓ | ✓ |
| SRO | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release