JPU-21678-09431
4 vaccinations
6 coded responses
42 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 020 / MA
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-05
Registered in v-safe
-
2021-03-05
Dose 1 — Moderna
- 2021-03-05
-
2021-03-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Nausea — Feeling: Good · Site: PainFree text: Last night I had moderate nausea, but it's gone today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-19
- 2021-03-26
-
2021-04-02
Dose 2 — Moderna
- 2021-04-02
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-07-02
- 2021-10-01
-
2021-10-27
Dose 3 — ModernaCo-administered: Flu:Tetanus
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Contusion — Feeling: Fair · Site: Pain, Redness, SwellingFree text: BruisingMedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Asthma, Pre-existing disease — Feeling: GoodFree text: Increased asthma, but likely because of season change and hayfeverMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-11
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
-
2022-01-26
Survey response — 3 months, dose 3MedDRA: Staphylococcal infection — 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 consultation, Emergency room or emergency department visit, HospitalizationFree text: MRSA infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
Report sent to call center — 3 months, dose 3Be 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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-01-29
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-27
-
2022-09-12
Dose 4 — ModernaCo-administered: Flu
- 2022-10-20
-
2022-10-26
Survey response — day 42, dose 4MedDRA: Gastrooesophageal reflux disease, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Acid reflux has increased · Healthcare visit (other): Talked to my primary care doctor during physical examMedDRA releases: 2024-11 · check-in free text available
-
2022-10-26
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2022-10-27
Call successfulCompleted over the phone
-
2022-12-12
Survey response — 3 months, dose 4MedDRA: Chest discomfort, Diarrhoea, Dizziness, Heart rate increased, Nausea, Palpitations, Paranasal sinus discomfort, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Diarrhea, nausea, sinus pressure, dizziness, heaviness in my chest, rapid heart pounding · Healthcare visit (other): I will be seeing my family doctor tomorrow morning.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-12
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-12-14
Call successfulCompleted over the phone
- 2023-03-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna | |
| 3 | 2021-10-27 | Moderna | Flu:Tetanus |
| 4 | 2022-09-12 | Moderna | Flu |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 2
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Last night I had moderate nausea, but it's gone today.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Bruising
Systemic reaction (other): Increased asthma, but likely because of season change and hayfever
Release 11 — 3 months, dose 3
Symptoms: MRSA infection
Release 12 — day 42, dose 4
Symptoms: Acid reflux has increased
Healthcare visit (other): Talked to my primary care doctor during physical exam
Release 12 — 3 months, dose 4
Symptoms: Diarrhea, nausea, sinus pressure, dizziness, heaviness in my chest, rapid heart pounding
Healthcare visit (other): I will be seeing my family doctor tomorrow morning.
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 | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Gastrooesophageal reflux disease | · | · | ✓ |
| SD | Heart rate increased | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Staphylococcal infection | · | · | ✓ |
| SRO | Asthma | · | · | ✓ |
| SRO | Contusion | · | · | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release