536-22873-82005
3 vaccinations
6 coded responses
34 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 609 / IL
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
DVR-32309-99968
Child or adolescent in my care · Male · 2021-12-05
D9G-29994-14068
Child or adolescent in my care · Male · 2021-12-05
Timeline
-
2021-03-10
Registered in v-safe
-
2021-03-10
Dose 1 — Moderna
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-24
- 2021-03-31
-
2021-04-07
Dose 2 — Moderna
- 2021-04-07
-
2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Neck pain — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activitiesFree text: Not sure if related but my neck/shoulder on opposite side of where I got shot is very painful today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-04-11
-
2021-04-12
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Headache, Nausea, Vomiting, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-04-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-04-14
Health check-in — day 7, dose 2Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-21
- 2021-04-28
-
2021-05-05
Survey response — day 28, dose 2MedDRA: Condition aggravated, Diarrhoea, Dysmenorrhoea — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesFree text: When I started my period I experienced unusually severe cramping and diarrhea for the first day or so.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-12
- 2021-05-19
- 2021-07-07
- 2021-10-06
-
2021-12-05
Dose 3 — Moderna
- 2021-12-05
-
2021-12-06
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-12-07
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy, Palpitations — Feeling: Fair · Site: Pain, Redness, SwellingFree text: Armpit lymph node swelling, heart palpitationsMedDRA releases: 2024-11 · check-in free text available
- 2021-12-11
-
2021-12-19
Survey response — day 14, dose 3MedDRA: Lymph node pain — Feeling: FairFree text: Under arm lymph node painMedDRA releases: 2024-11 · check-in free text available
- 2021-12-26
-
2022-01-08
Survey response — day 28, dose 3MedDRA: Influenza, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I had a very bad cold or flu. Tested three times for Covid all negativeMedDRA releases: 2024-11 · check-in free text available
- 2022-03-06
-
2022-12-07
Survey response — 12 months, dose 3MedDRA: Pregnancy, Type 2 diabetes mellitus — 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 · HospitalizationFree text: Type 2 Diabetes PregnancyMedDRA releases: 2024-11 · check-in free text available
-
2022-12-07
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
- 2022-12-08
- 2022-12-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Moderna | |
| 2 | 2021-04-07 | Moderna | |
| 3 | 2021-12-05 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-07 | Unsuccessful |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Not sure if related but my neck/shoulder on opposite side of where I got shot is very painful today.
Release 8 — day 28, dose 2
Symptoms: When I started my period I experienced unusually severe cramping and diarrhea for the first day or so.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Armpit lymph node swelling, heart palpitations
Release 10 — day 14, dose 3
Symptoms: Under arm lymph node pain
Release 10 — day 28, dose 3
Symptoms: I had a very bad cold or flu. Tested three times for Covid all negative
Release 12 — 12 months, dose 3
Symptoms: Type 2 Diabetes Pregnancy
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 | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dysmenorrhoea | ✓ | ✓ | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Lymph node pain | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Type 2 diabetes mellitus | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Palpitations | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release