77W-21779-78626
2 vaccinations
4 coded responses
16 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 972 / OR
- 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
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue, Pain — Feeling: Good · Site: PainFree text: Body aches 3 hours after injection, extreme fatigue day after injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-15
- 2021-01-16
- 2021-01-18
- 2021-01-19
-
2021-01-26
Survey response — day 14, dose 1MedDRA: COVID-19 — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: I was diagnosed with COVID-19 on 1/21.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-02
Survey response — day 21, dose 1MedDRA: Chest discomfort, Chest pain, Facial discomfort, Facial pain, Hypoaesthesia, Paraesthesia — Feeling: Poor · Be unable to workFree text: Numbness and tingling to the extremities and faceChest pain/discomfortMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
-
2021-02-09
Dose 2 — Moderna
- 2021-02-09
-
2021-02-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
-
2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-02-12
- 2021-02-13
- 2021-02-14
-
2021-02-15
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia — Feeling: FairFree text: Numbness in hands and feetMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-16
- 2021-08-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-09 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-02 | priority 2/3 |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Body aches 3 hours after injection, extreme fatigue day after injection
Release 2 — day 14, dose 1
Symptoms: I was diagnosed with COVID-19 on 1/21.
Release 3 — day 21, dose 1
Symptoms: Numbness and tingling to the extremities and faceChest pain/discomfort
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Numbness in hands and feet
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 | Chest discomfort | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | COVID-19 | ✓ | ✓ | ✓ |
| SD | Facial discomfort | ✓ | ✓ | ✓ |
| SD | Facial pain | ✓ | ✓ | ✓ |
| SD | Hypoaesthesia | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release