Y28-24691-78161
6 vaccinations
9 coded responses
75 check-ins
7 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 981 / WA
- Registered
- 2021-01-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Registered in v-safe
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2021-01-27
Dose 1 — Moderna
- 2021-01-27
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2021-01-28
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Sore upper arm (injection arm)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
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2021-02-12
Survey response — day 14, dose 1MedDRA: Hordeolum, Office visit, Periorbital cellulitis — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Stye in right eye getting worse despite erythromycin ointment; new diagnosis of preseptal cellulitis, now being treated with two oral antibiotics. · Healthcare visit (other): Primary care visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-17
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tirednessAdult check-in
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2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · HeadacheAdult check-in
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2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tirednessAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-03-03
- 2021-03-10
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2021-03-17
Survey response — day 21, dose 2MedDRA: Fungal infection — Feeling: GoodFree text: Yeast infection?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Survey response — day 28, dose 2MedDRA: Vulvovaginal inflammation — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Vaginal inflammationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-31
- 2021-04-07
- 2021-05-26
- 2021-08-01
- 2021-08-25
-
2021-10-25
Dose 3 — Moderna
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2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
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2022-01-24
Survey response — 3 months, dose 3MedDRA: Back pain, Fatigue, Headache, Office visit, SARS-CoV-2 test negative — Feeling: Fair · 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: Symptoms: Headache, fatigue, lower back pain. COVID test (PCR) negative 12/23 · Healthcare visit (other): Regular pcp visit plus radiology visitsMedDRA releases: 2024-11 · check-in free text available
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2022-01-24
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-01-27
- 2022-02-01
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2022-04-23
Dose 4 — Moderna
- 2022-04-23
-
2022-04-24
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness · HeadacheAdult check-in
-
2022-04-25
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2022-04-26
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tirednessAdult check-in
- 2022-04-27
-
2022-04-28
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2022-04-29
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-05-28
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2022-07-23
Survey response — 3 months, dose 4MedDRA: Small intestinal obstruction — 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 · Emergency room or emergency department visit, HospitalizationFree text: Adhesive small bowel obstructionMedDRA releases: 2024-11 · check-in free text available
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2022-07-23
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-07-25
- 2022-07-25
- 2022-07-25
- 2022-07-25
-
2022-09-19
Dose 5 — Pfizer-BioNTech
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2022-09-20
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2022-09-21
- 2022-09-22
- 2022-09-23
- 2022-09-24
- 2022-09-25
- 2022-09-26
- 2022-10-03
-
2022-10-10
Survey response — day 21, dose 5MedDRA: Headache, Malaise, Pyrexia, SARS-CoV-2 test negative, Throat irritation — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Scratchy throat, headache, malaise, low grade fever. Antigen test fir COVID 10/9 was negative,MedDRA releases: 2024-11 · check-in free text available
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-12-19
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2023-03-20
Survey response — 6 months, dose 5MedDRA: Arthralgia, Pain in extremity — Feeling: FairMedDRA releases: 2024-11
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2023-05-04
Dose 6 — Pfizer-BioNTech
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2023-05-05
Health check-in — days 1–6 daily, dose 6Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2023-05-06
Health check-in — days 1–6 daily, dose 6Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2023-05-07
- 2023-05-08
- 2023-05-10
- 2023-05-11
- 2023-05-18
- 2023-05-25
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2023-06-01
Survey response — day 28, dose 6MedDRA: Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
- 2023-06-01
- 2023-06-02
- 2023-06-02
- 2023-06-02
- 2023-06-02
- 2023-06-02
- 2023-06-08
- 2023-06-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-23 | Moderna | No |
| 5 | 2022-09-19 | Pfizer-BioNTech | No |
| 6 | 2023-05-04 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-12 | Unsuccessful | |
| 2021-03-24 | Unsuccessful | |
| 2022-01-24 | Unsuccessful | |
| 2022-07-23 | Unsuccessful | |
| 2023-06-01 | Unsuccessful |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Sore upper arm (injection arm)
Release 4 — day 14, dose 1
Symptoms: Stye in right eye getting worse despite erythromycin ointment; new diagnosis of preseptal cellulitis, now being treated with two oral antibiotics.
Healthcare visit (other): Primary care visit
Release 5 — day 21, dose 2
Symptoms: Yeast infection?
Release 6 — day 28, dose 2
Symptoms: Vaginal inflammation
Release 11 — 3 months, dose 3
Symptoms: Headache, fatigue, lower back pain. COVID test (PCR) negative 12/23
Healthcare visit (other): Regular pcp visit plus radiology visits
Release 12 — 3 months, dose 4
Symptoms: Adhesive small bowel obstruction
Release 12 — day 21, dose 5
Symptoms: Scratchy throat, headache, malaise, low grade fever. Antigen test fir COVID 10/9 was negative,
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 | Arthralgia | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Fungal infection | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hordeolum | ✓ | ✓ | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Periorbital cellulitis | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Small intestinal obstruction | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SD | Vulvovaginal inflammation | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release