533-16509-05158
4 vaccinations
11 coded responses
39 check-ins
11 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 056 / VT
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Registered in v-safe
-
2021-03-11
Dose 1 — Moderna
- 2021-03-11
-
2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: GoodFree text: Just sore arm skiedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-14
-
2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pruritus — Feeling: GoodFree text: Was a little itchy at injected site yesterday not todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-18
-
2021-03-25
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pruritus — Feeling: GoodFree text: Redness and itchy on arm by vaccination last week Started Thursday fir a few days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
-
2021-04-08
Dose 2 — Moderna
- 2021-04-08
-
2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-04-10
-
2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Site: Redness, ItchingFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
-
2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: GoodFree text: 2 times got a little dizzy todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
-
2021-04-15
Survey response — day 7, dose 2MedDRA: Nasal congestion — Feeling: GoodFree text: Nose stuffinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-22
- 2021-04-30
-
2021-05-06
Survey response — day 28, dose 2MedDRA: Cough — Feeling: GoodFree text: Coughing spell in the morning has happened a few times upon waking upMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-13
- 2021-05-20
-
2021-07-08
Survey response — 3 months, dose 2MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: GoodFree text: A slight sore throat and nose stuffinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-10-08
-
2021-10-29
Dose 3 — Moderna
-
2021-10-29
Survey response — day 0, dose 3MedDRA: Pyrexia — Feeling: Good · FeverFree text: Only felt feverish the day after vaccinationMedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
- 2021-10-31
-
2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Cough — Feeling: GoodFree text: Periodic coughMedDRA releases: 2024-11 · check-in free text available
- 2021-11-04
- 2021-11-14
- 2021-11-19
- 2021-12-03
- 2021-12-10
-
2022-01-31
Survey response — 3 months, dose 3MedDRA: Arthralgia, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Shoulder pain, working on with different practitioners · Healthcare visit (other): Acupuncturist, ChiropraticMedDRA releases: 2024-11 · check-in free text available
-
2022-01-31
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2022-03-30
-
2022-03-31
Call successfulDoes not wish to fill out VAERS report
- 2022-05-01
-
2022-09-29
Dose 4 — Moderna
- 2022-10-14
- 2022-10-20
- 2022-11-04
- 2023-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-08 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-09-29 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Just sore arm skied
Systemic reaction (other): Was a little itchy at injected site yesterday not today
Release 6 — day 14, dose 1
Symptoms: Redness and itchy on arm by vaccination last week Started Thursday fir a few days.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): No
Systemic reaction (other): 2 times got a little dizzy today
Release 7 — day 7, dose 2
Systemic reaction (other): Nose stuffiness
Release 8 — day 28, dose 2
Symptoms: Coughing spell in the morning has happened a few times upon waking up
Release 9 — 3 months, dose 2
Symptoms: A slight sore throat and nose stuffiness
Release 10 — day 0, dose 3
Systemic reaction (other): Only felt feverish the day after vaccination
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Periodic cough
Release 11 — 3 months, dose 3
Symptoms: Shoulder pain, working on with different practitioners
Healthcare visit (other): Acupuncturist, Chiropratic
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 | Cough | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release