5KC-21582-44140
5 vaccinations
9 coded responses
54 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 100 / NY
- Registered
- 2021-02-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-17
Dose 1 — Moderna
-
2021-02-20
Registered in v-safe
-
2021-02-20
Dose 2 — Moderna
-
2021-02-20
Survey response — day 0, dose 2MedDRA: Dizziness — Feeling: GoodFree text: Light-headness/dizziness (mild)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-21
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Asthma, Chest pain, Dyspnoea, Pre-existing disease, Sensitivity to weather change — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Chest pain and difficulty breathing (not severe), but I have asthma and cold weather exacerbates itMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-23
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-05
- 2021-05-22
- 2021-08-21
-
2021-11-11
Dose 3 — Moderna
-
2021-11-11
Survey response — day 0, dose 3MedDRA: Dizziness — Feeling: Fair · Site: PainFree text: Dizziness (mild) after the shotMedDRA releases: 2024-11 · check-in free text available
-
2021-11-12
Survey response — days 1–6 daily, dose 3MedDRA: Disturbance in attention, Dizziness, Oropharyngeal pain — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tirednessFree text: Throat pain, lightheaded, difficulty concentratingMedDRA releases: 2024-11 · check-in free text available
-
2021-11-13
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
-
2021-11-14
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Diarrhea, Abdominal painAdult check-in
- 2021-11-16
- 2021-11-17
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-16
- 2021-12-23
-
2022-02-10
Survey response — 3 months, dose 3MedDRA: Asthma, Chest pain, Fatigue, Pre-existing disease — 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 · Telehealth, virtual health, or email health consultationFree text: Extremely tired, chest hurt from exacerbating my asthma.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-10
Report sent to call center — 3 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 prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-02-16
Call successfulReported to VAERS voluntarily prior to GDIT contact
- 2022-05-12
-
2022-05-19
Dose 4 — Moderna
- 2022-05-21
- 2022-05-22
- 2022-05-23
- 2022-05-24
- 2022-05-26
-
2022-06-02
Survey response — day 14, dose 4MedDRA: Ventricular extrasystoles — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Frequent PVCs (around 6 per minute) for the last 27 hoursMedDRA releases: 2024-11 · check-in free text available
- 2022-06-09
- 2022-06-16
- 2022-06-30
- 2022-08-18
-
2022-10-05
Dose 5 — Moderna
-
2022-10-05
Health check-in — day 0, dose 5Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-10-06
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-10-07
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-08
- 2022-10-09
- 2022-10-10
-
2022-10-11
Health check-in — days 1–6 daily, dose 5Feeling: Good · Fatigue or tiredness, DiarrheaAdult check-in
- 2022-10-12
- 2022-10-19
-
2022-10-28
Survey response — day 21, dose 5MedDRA: Failed in vitro fertilisation, Pre-existing disease — Feeling: Fair · Be unable to work or attend schoolFree text: I have had two failed embryo transfers (post IVF cycles done in 2019-2020). One failed before I got my bivalent booster (but after a full series + two boosters). The second failed less than 2 weeks after the bivalent booster.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-02
Survey response — day 28, dose 5MedDRA: Fatigue — Feeling: FairFree text: I'm very tired oftenMedDRA releases: 2024-11 · check-in free text available
- 2022-11-09
- 2022-11-18
-
2023-01-04
Survey response — 3 months, dose 5MedDRA: Emergency care, Medical counselling, Office visit, Ventricular extrasystoles — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitMedDRA releases: 2024-11
-
2023-01-04
Report sent to call center — 3 months, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
-
2023-01-05
Call successfulParticipant prefers to complete VAERS report online
- 2023-04-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-17 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
| 4 | 2022-05-19 | Moderna | No |
| 5 | 2022-10-05 | Moderna | No |
Call center
2 call center cases
2 successful
VAERS report filed, before or during a call: 1
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): Light-headness/dizziness (mild)
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Chest pain and difficulty breathing (not severe), but I have asthma and cold weather exacerbates it
Release 10 — day 0, dose 3
Systemic reaction (other): Dizziness (mild) after the shot
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Throat pain, lightheaded, difficulty concentrating
Release 11 — 3 months, dose 3
Symptoms: Extremely tired, chest hurt from exacerbating my asthma.
Release 11 — day 14, dose 4
Symptoms: Frequent PVCs (around 6 per minute) for the last 27 hours
Release 12 — day 21, dose 5
Symptoms: I have had two failed embryo transfers (post IVF cycles done in 2019-2020). One failed before I got my bivalent booster (but after a full series + two boosters). The second failed less than 2 weeks after the bivalent booster.
Release 12 — day 28, dose 5
Symptoms: I'm very tired often
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 | Emergency care | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Asthma | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Failed in vitro fertilisation | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Ventricular extrasystoles | · | · | ✓ |
| SRO | Asthma | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Disturbance in attention | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Sensitivity to weather change | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release