559-29008-20053
5 vaccinations
6 coded responses
45 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 986 / WA
- Registered
- 2021-01-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Registered in v-safe
-
2021-01-27
Dose 1 — Moderna
- 2021-01-27
- 2021-01-28
-
2021-01-29
Survey response — days 1–6 daily, dose 1MedDRA: Lymphadenopathy — Feeling: FairFree text: Lymph node swelling under jaw on same side (L) ) as shot.asMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-30
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Lymph nodes under jaw are resolving.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
-
2021-02-01
Survey response — days 1–6 daily, dose 1MedDRA: Lymphadenopathy, Odynophagia — Feeling: FairFree text: Gladular swelling, some pain in swallowing both on L side.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
- 2021-02-03
- 2021-02-10
- 2021-02-17
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-05-26
- 2021-08-25
-
2021-11-09
Dose 3 — Moderna
- 2021-12-14
- 2021-12-21
- 2022-02-08
-
2022-04-09
Dose 4 — Moderna
- 2022-04-15
- 2022-04-16
- 2022-04-23
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-07-09
-
2022-09-12
Dose 5 — Moderna
-
2022-09-15
Survey response — days 1–6 daily, dose 5MedDRA: Brain fog — Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Brain fogMedDRA releases: 2024-11 · check-in free text available
- 2022-09-16
- 2022-09-19
- 2022-10-03
-
2022-10-10
Survey response — day 28, dose 5MedDRA: Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Minor sore throat, runny nose. I took a home Covid test today, 10/10/22, and tested positive for Covid.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-10
Report sent to call center — day 28, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-10-11
Call successfulParticipant prefers to complete VAERS report online
- 2022-10-17
-
2022-10-26
Survey response — day 42, dose 5MedDRA: COVID-19, Malaise, Quarantine, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Light symptoms started 10/25, home tested positive for COVID on 10/26. I suspect it is Paxlovid rebound. I am quarantining for 5 days. Will wear mask for 10 days from start of symptoms.MedDRA releases: 2024-11 · check-in free text available
- 2022-12-12
- 2023-03-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
| 4 | 2022-04-09 | Moderna | No |
| 5 | 2022-09-12 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Lymph node swelling under jaw on same side (L) ) as shot.as
Systemic reaction (other): Lymph nodes under jaw are resolving.
Systemic reaction (other): Gladular swelling, some pain in swallowing both on L side.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Brain fog
Release 12 — day 28, dose 5
Symptoms: Minor sore throat, runny nose. I took a home Covid test today, 10/10/22, and tested positive for Covid.
Release 12 — day 42, dose 5
Symptoms: Light symptoms started 10/25, home tested positive for COVID on 10/26. I suspect it is Paxlovid rebound. I am quarantining for 5 days. Will wear mask for 10 days from start of symptoms.
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 | COVID-19 | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Quarantine | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Odynophagia | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release