5PH-22662-63060
3 vaccinations
9 coded responses
39 check-ins
9 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 258 / WV
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Dose 1 — Moderna
-
2021-01-14
Registered in v-safe
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-26
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2021-02-02
Survey response — day 21, dose 1MedDRA: Headache, Hypersensitivity, Vertigo — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Allergies/vertigo, headaches occasionally.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-09
Dose 2 — Moderna
- 2021-02-09
-
2021-02-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Pain — Feeling: Fair · Headache, Muscle or body achesFree text: Pain under left arm, almost in armpit. Hurts when i move my left arm. Started last night around 10PM.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Muscle or body achesFree text: Not really but every female i know who has had her second shot had side effects but none of the males i know had any. Unfortunately none of them bothered to sign in with vsafe.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
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2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Vertigo — Feeling: Good · Be unable to do your normal daily activitiesFree text: Some vertigo. Not sure if sinus, allergies or what.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
- 2021-02-23
- 2021-03-02
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2021-03-09
Survey response — day 28, dose 2MedDRA: Nasal discomfort, Rhinorrhoea, Secretion discharge, Sinus disorder, Sinusitis, Skin erosion — Feeling: Good · Be unable to do your normal daily activitiesFree text: Ive had worsening sinus problems since 1st shot& it continues to get worse. My nose raw inside & out from all the blowing but clear not discolored like sinus infection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-23
- 2021-05-11
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2021-08-10
Survey response — 6 months, dose 2MedDRA: Arthritis, Ear pain, Middle ear effusion, Office visit, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Severe flare up of arthritis in rat hip. Had to get a shot under flouroscope but nothing related to COVID . Also had fluid in right ear with severe pain · Healthcare visit (other): Rheumatologist saw me in the officeMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-10
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-17
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2021-10-27
Dose 3 — Moderna
- 2021-10-27
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2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body achesAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
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2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Good · Joint pains, Muscle or body achesAdult check-in
- 2021-11-03
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2021-11-10
Survey response — day 14, dose 3MedDRA: Eye pruritus, Lacrimation increased, Pre-existing disease, Rash — Feeling: GoodFree text: Have a rash under both eyes. Eyes are watering and itching something fierce. I do have allergies but I've never had anything quite like this.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-17
- 2021-11-24
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2021-12-01
Survey response — day 35, dose 3MedDRA: Herpes zoster, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Woke up Thanksgiving morning with shingles on left shoulder. Started antiviral on Friday. Almost completely cleared up now. This was second time I had shingles. First time was when I was 49. Got a shingles shot in my 50s but still got them again!MedDRA releases: 2024-11 · check-in free text available
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2021-12-01
Report sent to call center — day 35, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-02
- 2021-12-06
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2021-12-06
Call successfulReported to VAERS voluntarily prior to GDIT contact
- 2021-12-08
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2022-01-26
Survey response — 3 months, dose 3MedDRA: Arthritis, Herpes zoster, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Accute arthritis flareup in right hip. Not sure when last check in was so not sure if I informed you that I had shingles day after Thanksgiving · Healthcare visit (other): MRI on hipMedDRA releases: 2024-11 · check-in free text available
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2022-01-26
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-27
- 2022-01-28
- 2022-04-27
- 2022-10-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-09 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
Call center
3 call center cases
2 successful · 1 unsuccessful
VAERS report filed, before or during a call: 2
Free text
Release 3 — day 21, dose 1
Symptoms: Allergies/vertigo, headaches occasionally.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Pain under left arm, almost in armpit. Hurts when i move my left arm. Started last night around 10PM.
Systemic reaction (other): Not really but every female i know who has had her second shot had side effects but none of the males i know had any. Unfortunately none of them bothered to sign in with vsafe.
Systemic reaction (other): Some vertigo. Not sure if sinus, allergies or what.
Release 5 — day 28, dose 2
Symptoms: Ive had worsening sinus problems since 1st shot& it continues to get worse. My nose raw inside & out from all the blowing but clear not discolored like sinus infection.
Release 9 — 6 months, dose 2
Symptoms: Severe flare up of arthritis in rat hip. Had to get a shot under flouroscope but nothing related to COVID . Also had fluid in right ear with severe pain
Healthcare visit (other): Rheumatologist saw me in the office
Release 10 — day 14, dose 3
Symptoms: Have a rash under both eyes. Eyes are watering and itching something fierce. I do have allergies but I've never had anything quite like this.
Release 10 — day 35, dose 3
Symptoms: Woke up Thanksgiving morning with shingles on left shoulder. Started antiviral on Friday. Almost completely cleared up now. This was second time I had shingles. First time was when I was 49. Got a shingles shot in my 50s but still got them again!
Release 11 — 3 months, dose 3
Symptoms: Accute arthritis flareup in right hip. Not sure when last check in was so not sure if I informed you that I had shingles day after Thanksgiving
Healthcare visit (other): MRI on hip
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 | ✓ | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Arthritis | ✓ | · | ✓ |
| SD | Ear pain | ✓ | · | ✓ |
| SD | Eye pruritus | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Herpes zoster | · | · | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Lacrimation increased | · | · | ✓ |
| SD | Middle ear effusion | ✓ | · | ✓ |
| SD | Nasal discomfort | ✓ | ✓ | ○ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Secretion discharge | ✓ | ✓ | ○ |
| SD | Sinus disorder | ✓ | ✓ | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SD | Skin erosion | · | · | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release