4YJ-28154-81162
2 vaccinations
6 coded responses
22 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 600 / IL
- Registered
- 2021-04-26
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-04-26
Registered in v-safe
-
2021-04-26
Dose 1 — Moderna
-
2021-04-26
Survey response — day 0, dose 1MedDRA: Vision blurred — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tirednessFree text: Slight blurry visionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-27
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea, Palpitations — Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal painFree text: Periodically racing heart palpitations while walking around the house, trouble breathing off and on through the dayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-28
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea, Palpitations — Feeling: Poor · Site: Pain · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Racing heart palpitations, shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
-
2021-04-30
Survey response — days 1–6 daily, dose 1MedDRA: Palpitations — Feeling: Fair · Fatigue or tirednessFree text: Heart racingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-05-24
-
2021-05-27
Dose 2 — Moderna
- 2021-05-31
- 2021-06-01
- 2021-06-02
- 2021-06-03
- 2021-06-10
- 2021-06-17
- 2021-06-24
-
2021-07-03
Survey response — day 35, dose 2MedDRA: Ageusia, Anosmia, Headache, Rhinorrhoea, Sinusitis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I have a sinus infection. I have a runny nose, headache, and loss of smell & taste.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-08
- 2021-08-26
- 2021-11-25
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2022-05-30
Survey response — 12 months, dose 2MedDRA: Nasopharyngitis — 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 professional · Outpatient clinic or urgent care clinic visitFree text: ColdMedDRA releases: 2024-11 · check-in free text available
-
2022-05-30
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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-06-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-26 | Moderna | |
| 2 | 2021-05-27 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-30 | Unsuccessful |
Free text
Release 8 — day 0, dose 1
Systemic reaction (other): Slight blurry vision
Release 8 — days 1–6 daily, dose 1
Systemic reaction (other): Periodically racing heart palpitations while walking around the house, trouble breathing off and on through the day
Systemic reaction (other): Racing heart palpitations, shortness of breath
Systemic reaction (other): Heart racing
Release 9 — day 35, dose 2
Symptoms: I have a sinus infection. I have a runny nose, headache, and loss of smell & taste.
Release 11 — 12 months, dose 2
Symptoms: Cold
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 |
|---|---|---|---|---|
| SD | Ageusia | ✓ | ✓ | ✓ |
| SD | Anosmia | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Vision blurred | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release