VHP-32407-86573
4 vaccinations
2 coded responses
35 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 045 / ME
- Registered
- 2020-12-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
89L-25484-20368
Child or adolescent in my care · Male · 2022-09-21
Timeline
-
2020-12-28
Dose 1 — Moderna
-
2020-12-29
Registered in v-safe
-
2020-12-29
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2020-12-30
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2020-12-31
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
-
2021-01-11
Survey response — day 14, dose 1MedDRA: Injection site erythema, Vaccination site pruritus, Vaccination site swelling — Feeling: GoodFree text: Redness, swelling, and pruritus at the vaccination site developed 1/5/21 and persisted until 1/8/21MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-01-27
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-04-26
-
2021-07-26
Survey response — 6 months, dose 2MedDRA: Headache, Idiopathic intracranial hypertension, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Diagnosed with idiopathic intracranial hypertension due developiny an intractable positional headache · Healthcare visit (other): Procedure and imagingMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-26
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-27
- 2021-07-27
-
2021-07-27
Call successfulParticipant prefers to complete VAERS report online
-
2021-11-11
Dose 3 — Moderna
- 2022-01-25
- 2022-05-12
-
2022-09-15
Dose 4 — Pfizer-BioNTech
- 2022-09-21
-
2022-09-22
Health check-in — day 7, dose 4Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2022-09-29
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-10-27
- 2022-12-15
- 2023-03-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
| 4 | 2022-09-15 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-26 | Successful 2021-07-27 |
Participant prefers to complete VAERS report online |
Free text
Release 1 — day 14, dose 1
Symptoms: Redness, swelling, and pruritus at the vaccination site developed 1/5/21 and persisted until 1/8/21
Release 9 — 6 months, dose 2
Symptoms: Diagnosed with idiopathic intracranial hypertension due developiny an intractable positional headache
Healthcare visit (other): Procedure and imaging
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 | Unevaluable event | ✓ | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Idiopathic intracranial hypertension | ✓ | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Vaccination site pruritus | ✓ | ✓ | ✓ |
| SD | Vaccination site swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release