J9R-21247-54052
3 vaccinations
5 coded responses
26 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 787 / TX
- Registered
- 2021-04-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-02
Dose 1 — Moderna
-
2021-04-10
Registered in v-safe
-
2021-04-10
Survey response — day 7, dose 1MedDRA: Herpes zoster — Feeling: Poor · Site: Pain · Headache, Rash, not including the immediate area around the injection site · 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: Diagnosed with shingles yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-10
Report sent to call center — day 7, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-16
-
2021-04-25
Survey response — day 21, dose 1MedDRA: Oropharyngeal pain, Pyrexia — Feeling: FairFree text: Sore throat, low feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-30
Dose 2 — Moderna
-
2021-04-30
Health check-in — day 0, dose 2Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to workAdult check-in
-
2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness · Be unable to workAdult check-in
-
2021-05-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness · Fatigue or tirednessAdult check-in
- 2021-05-04
- 2021-05-05
-
2021-05-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-05-07
-
2021-05-14
Survey response — day 14, dose 2MedDRA: Paranasal sinus discomfort, Rhinorrhoea — Feeling: FairFree text: Sinus pressure and runny noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-21
- 2021-05-30
-
2021-06-04
Survey response — day 35, dose 2MedDRA: Fatigue, Pruritus — Feeling: FairFree text: Random tingling and itching, some muscle fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-11
Survey response — day 42, dose 2MedDRA: Paraesthesia, Pruritus — Feeling: FairFree text: Tingling and itching randomly in different places around body.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-31
- 2021-10-31
-
2021-12-30
Dose 3 — Moderna
-
2022-01-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend schoolAdult check-in
-
2022-01-06
Health check-in — day 7, dose 3Feeling: Fair · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2022-01-13
- 2022-01-20
- 2022-01-27
- 2022-02-05
- 2022-02-10
-
2022-03-17
Call successfulParticipant prefers to complete VAERS report online
- 2022-04-02
- 2022-07-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-02 | Moderna | |
| 2 | 2021-04-30 | Moderna | |
| 3 | 2021-12-30 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 7 — day 7, dose 1
Systemic reaction (other): Diagnosed with shingles yesterday
Release 7 — day 21, dose 1
Symptoms: Sore throat, low fever
Release 8 — day 14, dose 2
Symptoms: Sinus pressure and runny nose
Release 8 — day 35, dose 2
Symptoms: Random tingling and itching, some muscle fatigue
Release 9 — day 42, dose 2
Symptoms: Tingling and itching randomly in different places around body.
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 | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SD | Paranasal sinus discomfort | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Herpes zoster | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release