6DL-22535-99913
3 vaccinations
5 coded responses
38 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 31-35
- ZIP prefix
- 200 / DC
- Registered
- 2021-04-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
NRG-33425-10173
Child or adolescent in my care · Male · 2022-06-23
Timeline
-
2021-04-17
Registered in v-safe
-
2021-04-17
Dose 1 — Moderna
- 2021-04-17
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-05-01
- 2021-05-10
-
2021-05-15
Dose 2 — Moderna
- 2021-05-15
-
2021-05-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
-
2021-05-17
Survey response — days 1–6 daily, dose 2MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Sore throat (mild)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-18
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-05-19
- 2021-05-20
- 2021-05-21
- 2021-05-22
- 2021-05-29
- 2021-06-05
- 2021-06-12
- 2021-06-19
- 2021-06-26
-
2021-08-14
Survey response — 3 months, dose 2MedDRA: Fatigue, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — Feeling: FairFree text: I have been sick twice between June 11-present, with cold-like symptoms (sore throat, congestion, runny nose, fatigue) after my child started attending daycare and became sick. My child tested negative for COVID-19 both times he was sick.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-11-15
-
2021-12-01
Dose 3 — Moderna
-
2021-12-02
Survey response — days 1–6 daily, dose 3MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Swelling under the armpit on the left arm (injection was in left arm)MedDRA releases: 2024-11 · check-in free text available
-
2021-12-04
Survey response — days 1–6 daily, dose 3MedDRA: Oedema peripheral — Feeling: Good · Site: Pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Still have swelling below left armpit, after getting vaccine in left armMedDRA releases: 2024-11 · check-in free text available
-
2021-12-04
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-08
- 2021-12-08
-
2021-12-08
Call successfulParticipant prefers to complete VAERS report online
- 2021-12-15
- 2021-12-22
- 2021-12-29
- 2022-01-05
- 2022-01-12
-
2022-03-02
Survey response — 3 months, dose 3MedDRA: Abdominal pain upper, Cough, Respiratory tract congestion, Vomiting — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: 1 instance of old symptoms (cough, congestion); 1 separate instance of stomachaches and vomiting.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-01
- 2022-12-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-17 | Moderna | |
| 2 | 2021-05-15 | Moderna | |
| 3 | 2021-12-01 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Sore throat (mild)
Release 9 — 3 months, dose 2
Symptoms: I have been sick twice between June 11-present, with cold-like symptoms (sore throat, congestion, runny nose, fatigue) after my child started attending daycare and became sick. My child tested negative for COVID-19 both times he was sick.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Swelling under the armpit on the left arm (injection was in left arm)
Systemic reaction (other): Still have swelling below left armpit, after getting vaccine in left arm
Release 11 — 3 months, dose 3
Symptoms: 1 instance of old symptoms (cough, congestion); 1 separate instance of stomachaches and vomiting.
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 | Abdominal pain upper | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SD | Rhinorrhoea | ✓ | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release