6YZ-10155-89782
2 vaccinations
6 coded responses
19 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 236 / VA
- Registered
- 2021-04-07
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-02
Dose 1 — Moderna
-
2021-04-07
Registered in v-safe
-
2021-04-07
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-08
Survey response — days 1–6 daily, dose 1MedDRA: Mass, Pruritus — Feeling: GoodFree text: Itchy lump in scalp- probably not due to the shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-09
- 2021-04-16
-
2021-04-23
Survey response — day 21, dose 1MedDRA: Injection site pain, Injection site pruritus — Feeling: GoodFree text: The spot where I receive the vaccination was itching and slight painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-30
Dose 2 — Moderna
- 2021-04-30
-
2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-05
-
2021-05-06
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: GoodFree text: I was feeling slightly dizzy close to evening time for the past 2 days. My head (forehead) area waMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-16
- 2021-05-21
- 2021-06-04
- 2021-06-11
- 2021-08-01
-
2021-10-29
Survey response — 6 months, dose 2MedDRA: Fatigue, Hepatic enzyme increased, Rhinorrhoea — Feeling: GoodFree text: Just runny nose and fatigue. May be due to working the overnight shift. My doctor said that I MAY HAVE HAD A virus, because my liver enzyme readings were very high. The readings are back to normal nowMedDRA releases: 2024-11 · check-in free text available
-
2022-05-02
Survey response — 12 months, dose 2MedDRA: Flank pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Had slight pain on Left side -Don't know if it was related to vaccineMedDRA releases: 2024-11 · check-in free text available
-
2022-05-02
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-03
-
2022-05-03
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-02 | Moderna | |
| 2 | 2021-04-30 | Moderna |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): No
Systemic reaction (other): Itchy lump in scalp- probably not due to the shot
Release 7 — day 21, dose 1
Symptoms: The spot where I receive the vaccination was itching and slight pain
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): I was feeling slightly dizzy close to evening time for the past 2 days. My head (forehead) area wa
Release 10 — 6 months, dose 2
Symptoms: Just runny nose and fatigue. May be due to working the overnight shift. My doctor said that I MAY HAVE HAD A virus, because my liver enzyme readings were very high. The readings are back to normal now
Release 11 — 12 months, dose 2
Symptoms: Had slight pain on Left side -Don't know if it was related to vaccine
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 | Fatigue | · | · | ✓ |
| SD | Flank pain | · | · | ✓ |
| SD | Hepatic enzyme increased | · | · | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Mass | ✓ | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release