6VU-46014-09585
4 vaccinations
8 coded responses
39 check-ins
7 free-text entries
4 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 217 / MD
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-16
Dose 1 — Moderna
-
2021-01-17
Registered in v-safe
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-22
- 2021-01-23
- 2021-01-30
-
2021-02-06
Survey response — day 21, dose 1MedDRA: Fatigue, Flushing — Feeling: FairFree text: Fatigue and flushing of face for a couple days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Dose 2 — Moderna
- 2021-02-13
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Chest pain, Flank pain — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body achesFree text: Chest and flank pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
-
2021-05-15
Survey response — 3 months, dose 2MedDRA: Apathy, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Daily fatigue, decreased ambition, and headaches.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-14
Survey response — 6 months, dose 2MedDRA: Haematoma, Skin mass, Surgery — Feeling: Good · Be unable to work or attend schoolFree text: Large hematoma mass on back evacuated through surgery July 1.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-18
Dose 3 — Moderna
-
2021-10-26
Health check-in — day 7, dose 3Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2022-01-17
- 2022-04-21
-
2022-04-23
Dose 4 — Moderna
- 2022-05-03
- 2022-05-07
- 2022-05-14
-
2022-05-22
Survey response — day 28, dose 4MedDRA: Contusion, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Two 10cm bruises appears on left thigh without known trauma. Contacted physician and will be evaluated. This was the second time for such occurrence. · Healthcare visit (other): Appointment scheduled this coming week.MedDRA releases: 2024-11 · check-in free text available
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2022-05-22
Report sent to call center — day 28, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2022-05-23
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-29
- 2022-06-04
-
2022-07-05
Call successfulParticipant prefers to complete VAERS report online
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2022-07-23
Survey response — 3 months, dose 4MedDRA: Adverse reaction, Nasopharyngitis, SARS-CoV-2 test positive, Unevaluable event — Feeling: Fair · 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: Symptoms: Cold and allergy type symptoms. Tested positive for COVID-19. · Healthcare visit (other): Prescribed PraxlovidMedDRA releases: 2024-11 · check-in free text available
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2022-07-23
Report sent to call center — 3 months, 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)
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2022-10-22
Survey response — 6 months, dose 4MedDRA: COVID-19 — 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: Had COVID the week of June 26, 2022. This update does not provide reference to the last most recent update. Not sure if I already reported my COVID.MedDRA releases: 2024-11 · check-in free text available
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2022-10-22
Report sent to call center — 6 months, 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)
- 2022-10-25
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2023-04-23
Survey response — 12 months, dose 4MedDRA: COVID-19, 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 consultationMedDRA releases: 2024-11
-
2023-04-23
Report sent to call center — 12 months, 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)
- 2023-04-24
- 2023-04-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-13 | Moderna | |
| 3 | 2021-10-18 | Moderna | No |
| 4 | 2022-04-23 | Moderna | No |
Call center
4 call center cases
2 successful · 2 unsuccessful
Free text
Release 3 — day 21, dose 1
Symptoms: Fatigue and flushing of face for a couple days.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Chest and flank pain.
Release 8 — 3 months, dose 2
Symptoms: Daily fatigue, decreased ambition, and headaches.
Release 9 — 6 months, dose 2
Symptoms: Large hematoma mass on back evacuated through surgery July 1.
Release 11 — day 28, dose 4
Symptoms: Two 10cm bruises appears on left thigh without known trauma. Contacted physician and will be evaluated. This was the second time for such occurrence.
Healthcare visit (other): Appointment scheduled this coming week.
Release 12 — 3 months, dose 4
Symptoms: Cold and allergy type symptoms. Tested positive for COVID-19.
Healthcare visit (other): Prescribed Praxlovid
Release 12 — 6 months, dose 4
Symptoms: Had COVID the week of June 26, 2022. This update does not provide reference to the last most recent update. Not sure if I already reported my COVID.
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 | Unevaluable event | · | · | ✓ |
| SD | Adverse reaction | · | · | ✓ |
| SD | Apathy | ✓ | ✓ | ✓ |
| SD | Contusion | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Flushing | ✓ | ✓ | ✓ |
| SD | Haematoma | ✓ | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Skin mass | ✓ | · | ✓ |
| SD | Surgery | ✓ | · | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Flank pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release