H83-23659-00038
4 vaccinations
12 coded responses
45 check-ins
11 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 064 / CT
- Registered
- 2021-03-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
YMR-10393-77893
Child or adolescent in my care · Female · 2022-07-19
Timeline
-
2021-03-05
Dose 1 — Janssen/Johnson & Johnson
-
2021-03-07
Registered in v-safe
- 2021-03-07
-
2021-03-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · HeadacheAdult check-in
-
2021-03-09
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Site: Pain · HeadacheFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-17
-
2021-06-04
Survey response — 3 months, dose 1MedDRA: Nephrolithiasis — Feeling: Good · Be unable to do your normal daily activitiesFree text: Kidney stoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-09-03
Survey response — 6 months, dose 1MedDRA: Delivery — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: I had my baby.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-03
Report sent to call center — 6 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-11-01
Dose 2 — ModernaCo-administered: Flu
- 2021-11-02
- 2021-11-03
-
2021-11-04
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: GoodFree text: Underarm soreness on arm that received injectionMedDRA releases: 2024-11 · check-in free text available
-
2021-11-05
Survey response — days 1–6 daily, dose 2MedDRA: Tenderness — Feeling: GoodFree text: Sore underarm to touchMedDRA releases: 2024-11 · check-in free text available
- 2021-11-07
- 2021-11-08
- 2021-11-15
- 2021-11-29
- 2021-12-06
- 2021-12-13
-
2022-01-31
Survey response — 3 months, dose 2MedDRA: SARS-CoV-2 test positive — 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: I tested positive for covid-19 early JanuaryMedDRA releases: 2024-11 · check-in free text available
-
2022-01-31
Report sent to call center — 3 months, dose 2Be 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)
-
2022-02-01
Call successfulParticipant prefers to complete VAERS report online
- 2022-05-04
-
2022-05-10
Dose 3 — Moderna
-
2022-05-14
Survey response — days 1–6 daily, dose 3MedDRA: Ear discomfort — Feeling: Good · Site: PainFree text: Clogged earMedDRA releases: 2024-11 · check-in free text available
- 2022-05-15
- 2022-05-19
- 2022-05-24
- 2022-05-31
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2022-06-09
Survey response — day 28, dose 3MedDRA: Cough, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sore throat and a coughMedDRA releases: 2024-11 · check-in free text available
- 2022-06-14
- 2022-06-21
-
2022-08-09
Survey response — 3 months, dose 3MedDRA: Oropharyngeal pain — Feeling: FairFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
-
2022-11-06
Dose 4 — Moderna
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2022-11-07
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2022-11-10
- 2022-11-12
- 2022-11-13
-
2022-11-20
Survey response — day 14, dose 4MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
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2022-11-27
Survey response — day 21, dose 4MedDRA: Cough, Fatigue, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Congestion, fatigue, coughMedDRA releases: 2024-11 · check-in free text available
- 2022-12-04
- 2022-12-11
- 2022-12-18
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2023-02-05
Survey response — 3 months, dose 4MedDRA: Office visit, Pharyngitis streptococcal — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-02-05
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Get care from a doctor or other healthcare professional1 call case(s)
- 2023-02-06
- 2023-05-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-01 | Moderna | Flu |
| 3 | 2022-05-10 | Moderna | No |
| 4 | 2022-11-06 | Moderna | No |
Call center
3 call center cases
2 successful · 1 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Dizziness
Release 8 — 3 months, dose 1
Symptoms: Kidney stone
Release 9 — 6 months, dose 1
Symptoms: I had my baby.
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): Underarm soreness on arm that received injection
Systemic reaction (other): Sore underarm to touch
Release 11 — 3 months, dose 2
Symptoms: I tested positive for covid-19 early January
Release 11 — days 1–6 daily, dose 3
Systemic reaction (other): Clogged ear
Release 12 — day 28, dose 3
Symptoms: Sore throat and a cough
Release 12 — 3 months, dose 3
Symptoms: Sore throat
Release 12 — day 14, dose 4
Symptoms: Runny nose
Release 12 — day 21, dose 4
Symptoms: Congestion, fatigue, cough
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 | Office visit | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Delivery | ✓ | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Nephrolithiasis | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pharyngitis streptococcal | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Ear discomfort | · | · | ✓ |
| SRO | Tenderness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release