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Y2U-13592-17117

2 vaccinations 5 coded responses 13 check-ins 5 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
119 / NY
Registered
2021-01-28
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-20
    Dose 1 — Moderna
  2. 2021-01-28
    Registered in v-safe
  3. 2021-01-28
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling · None
    Adult check-in
  4. 2021-02-03
    Survey response — day 14, dose 1
    MedDRA: Erythema, Feeling hot, Induration, Pain in extremity, Peripheral swelling, Pruritus — Feeling: Good · Be unable to do your normal daily activities
    Free text: The red patch on my arm got worse for 3 days, it was about 4 inches in diameter and it hurt was hot and itchy and hard, slightly raised. Then it faded and is almost gone now.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-10
    Survey response — day 21, dose 1
    MedDRA: Arthralgia, Irritability, Neck pain, Pain in extremity — Feeling: Good
    Free text: Very sore arm, shoulder and neck of unexplained reason but not the same arm as shot was given. Extreme irritability in mood, also unexplained. I am considering these conditions unrelated to the vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-17
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-02-20
    Dose 2 — Moderna
  8. 2021-02-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-02-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fever · Headache · Be unable to do your normal daily activities
    Adult check-in
  11. 2021-03-06
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-03-13
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-03-20
    Survey response — day 28, dose 2
    MedDRA: Headache, Oropharyngeal pain — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Headache sore throat.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-27
    Survey response — day 35, dose 2
    MedDRA: Diarrhoea, Fatigue — Feeling: Good · Be unable to do your normal daily activities
    Free text: Very tiredLoose bowels.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-03
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-05-22
    Survey response — 3 months, dose 2
    MedDRA: Biopsy, Heavy menstrual bleeding, Office visit — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: I got my period and it bled heavily for 5.5 weeks. Thats is about 39 days. After 2 weeks, I got a trnsvaginal Ultrasound and a uterus biopsy that showed disordered proliferation endometrium. Ultrasound showed thick uterus lining of 20 mm if I reca · Healthcare visit (other): Went to Ob/gyn
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-05-22
    Report sent to call center — 3 months, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  18. 2022-04-14
  19. 2022-04-19

Vaccinations

DoseDateManufacturerCo-administered
12021-01-20Moderna
22021-02-20Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-05-22 Unsuccessful

Free text

Release 3 — day 14, dose 1

2021-02-03

Symptoms: The red patch on my arm got worse for 3 days, it was about 4 inches in diameter and it hurt was hot and itchy and hard, slightly raised. Then it faded and is almost gone now.

Release 4 — day 21, dose 1

2021-02-10

Symptoms: Very sore arm, shoulder and neck of unexplained reason but not the same arm as shot was given. Extreme irritability in mood, also unexplained. I am considering these conditions unrelated to the vaccine.

Release 6 — day 28, dose 2

2021-03-20

Symptoms: Headache sore throat.

Release 6 — day 35, dose 2

2021-03-27

Symptoms: Very tiredLoose bowels.

Release 8 — 3 months, dose 2

2021-05-22

Symptoms: I got my period and it bled heavily for 5.5 weeks. Thats is about 39 days. After 2 weeks, I got a trnsvaginal Ultrasound and a uterus biopsy that showed disordered proliferation endometrium. Ultrasound showed thick uterus lining of 20 mm if I reca
Healthcare visit (other): Went to Ob/gyn

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ ✓ ✓
SDArthralgia ✓ ✓ ✓
SDBiopsy ✓ ✓ ✓
SDDiarrhoea ✓ ✓ ✓
SDErythema ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDFeeling hot ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDHeavy menstrual bleeding ✓ ✓ ✓
SDInduration ✓ ✓ ✓
SDIrritability ✓ ✓ ✓
SDNeck pain ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDPeripheral swelling ✓ ✓ ✓
SDPruritus ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release