5PA-17106-55241
4 vaccinations
5 coded responses
33 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 112 / NY
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Dose 1 — Moderna
-
2021-01-16
Registered in v-safe
-
2021-01-16
Survey response — day 7, dose 1MedDRA: Erythema, Immediate post-injection reaction, Injection site swelling — Feeling: Good · Site: Pain, Redness, Itching · NauseaFree text: One week after vaccination I developed redness and swelling at the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
-
2021-01-30
Dose 2 — Moderna
- 2021-01-30
-
2021-01-31
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-01
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Very Swollen painful axillary lymph nodes on injection sideMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-02
Survey response — days 1–6 daily, dose 2MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Swollen, painful axillary lymph nodes on injection sideMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-03
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Fatigue or tirednessFree text: Axillary lymph node swelling in arm where injection was receivedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-13
- 2021-02-20
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-05-01
- 2021-07-31
-
2021-12-02
Dose 3 — Moderna
-
2022-01-30
Survey response — 12 months, dose 2MedDRA: Gestational hypertension, Pre-eclampsia — 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: #NAME?MedDRA releases: 2024-11 · check-in free text available
-
2022-01-30
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 prHospitalization · 1 call case(s)
- 2022-02-01
-
2022-10-28
Dose 4 — Pfizer-BioNTech
-
2022-10-28
Health check-in — day 0, dose 4Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-10-29
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-30
- 2022-10-31
- 2022-11-01
- 2022-11-02
- 2022-11-03
- 2022-11-06
- 2022-11-11
- 2022-11-18
- 2022-11-25
- 2022-12-02
- 2022-12-09
- 2023-01-27
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-01-30 | Moderna | |
| 3 | 2021-12-02 | Moderna | No |
| 4 | 2022-10-28 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-30 | Unsuccessful |
Free text
Release 2 — day 7, dose 1
Systemic reaction (other): One week after vaccination I developed redness and swelling at the injection site
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Very Swollen painful axillary lymph nodes on injection side
Systemic reaction (other): Swollen, painful axillary lymph nodes on injection side
Systemic reaction (other): Axillary lymph node swelling in arm where injection was received
Release 11 — 12 months, dose 2
Symptoms: #NAME?
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 | Gestational hypertension | · | · | ✓ |
| SD | Pre-eclampsia | · | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release