67Z-33748-40414
4 vaccinations
6 coded responses
28 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 054 / VT
- Registered
- 2021-01-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-09
Registered in v-safe
- 2021-01-09
- 2021-01-10
-
2021-01-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-01-12
-
2021-01-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-01-14
- 2021-01-15
-
2021-01-22
Survey response — day 14, dose 1MedDRA: Headache — Feeling: GoodFree text: Just a headache today. It came and went. I suspect its just a work related headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
-
2021-02-05
Dose 2 — Moderna
-
2021-02-05
Survey response — day 0, dose 2MedDRA: Injection site pain — Feeling: Good · Muscle or body achesFree text: A little soreness around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Eye pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Occasional shooting pain in right eyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
-
2021-05-07
Survey response — 3 months, dose 2MedDRA: Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sore throat off and onSwollen glands off and onMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-07
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-07
Survey response — 6 months, dose 2MedDRA: Eustachian tube disorder, Hypoacusis, Sinus congestion — Feeling: GoodFree text: On hot and humid days sinuses/eustachian tubes fill with fluid, causing sound to reverberate. This is the 1st summer its happened. May be coincidental.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-29
Dose 3 — Moderna
- 2022-02-05
- 2022-04-18
-
2022-09-26
Dose 4 — ModernaCo-administered: Flu
-
2022-09-29
Survey response — days 1–6 daily, dose 4MedDRA: Brain fog, Irritability, SARS-CoV-2 test positive — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, 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 activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Irritability & brain fog , too. I tested positive for COVID this AM.MedDRA releases: 2024-11 · check-in free text available
-
2022-09-29
Report sent to call center — days 1–6 daily, dose 4Be 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)
-
2022-09-30
Call successfulParticipant prefers to complete VAERS report online
-
2022-09-30
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-02
- 2022-12-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-05 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-09-26 | Moderna | Flu |
Call center
2 call center cases
2 successful
1 wait over 3 months for a first call
Free text
Release 2 — day 14, dose 1
Symptoms: Just a headache today. It came and went. I suspect its just a work related headache.
Release 3 — day 0, dose 2
Systemic reaction (other): A little soreness around the injection site
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Occasional shooting pain in right eye
Release 8 — 3 months, dose 2
Symptoms: Sore throat off and onSwollen glands off and on
Release 9 — 6 months, dose 2
Symptoms: On hot and humid days sinuses/eustachian tubes fill with fluid, causing sound to reverberate. This is the 1st summer its happened. May be coincidental.
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Irritability & brain fog , too. I tested positive for COVID this AM.
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 | Eustachian tube disorder | ✓ | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hypoacusis | ✓ | · | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Sinus congestion | ✓ | · | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Irritability | · | · | ✓ |
| SRO | SARS-CoV-2 test positive | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release