Y39-27502-88621
4 vaccinations
16 coded responses
50 check-ins
15 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 777 / TX
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-01
Dose 1 — Moderna
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2021-03-02
Registered in v-safe
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2021-03-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
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2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body achesFree text: Its more tenderness than pain at the injection area.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-03-29
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2021-03-30
Dose 2 — Moderna
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2021-04-05
Survey response — day 35, dose 1MedDRA: Injection site pain, Injection site swelling, Nausea — Feeling: Good · Be unable to do your normal daily activitiesFree text: Excessive pain & swelling at injection site. The next day I had a temperature and experienced nausea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Injection site pain, Injection site swelling, Nausea, Pain, Pain in extremity, Pyrexia, Tenderness — Feeling: Good · Be unable to do your normal daily activitiesFree text: The day after I received my 2nd vaccine I had had excessive swelling at the injection site and it was painful to move my arm. I also had a temperature of 100.8 & was nauseous the next day. The 2nd day after vaccination my temperature was lower, 99.8. No nausea and the swelling and tenderness was reduced & I was able to move my are easily. 3rd day my temperature had returned to normal and no nausea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
- 2021-04-13
- 2021-04-20
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2021-04-27
Survey response — day 28, dose 2MedDRA: Nasopharyngitis — Feeling: GoodFree text: Ive had a cold since Thursday last week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-04
- 2021-05-11
- 2021-06-29
- 2021-09-28
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2021-11-03
Dose 3 — Moderna
- 2021-11-03
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2021-11-04
Survey response — days 1–6 daily, dose 3MedDRA: Pre-existing disease — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body achesFree text: Those selected are daily maladies I've dealt with prior to being vaccinated.MedDRA releases: 2024-11 · check-in free text available
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2021-11-05
Survey response — days 1–6 daily, dose 3MedDRA: Pre-existing disease — Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body achesFree text: The joint & muscle pain are pre-existing due to orthopedic problems!MedDRA releases: 2024-11 · check-in free text available
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2021-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Pre-existing disease — Feeling: Good · Joint pains, Muscle or body achesFree text: Due to pre-existing conditions.MedDRA releases: 2024-11 · check-in free text available
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2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Pre-existing disease — Feeling: Good · Joint pains, Muscle or body achesFree text: Those checked are due to pre-existing conditions.MedDRA releases: 2024-11 · check-in free text available
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2021-11-08
Survey response — days 1–6 daily, dose 3MedDRA: Pre-existing disease — Feeling: Good · Headache, Joint pains, Muscle or body achesFree text: Allergies and other pre-existing orthopedic conditions.MedDRA releases: 2024-11 · check-in free text available
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2021-11-09
Survey response — days 1–6 daily, dose 3MedDRA: Arthralgia, Headache, Pre-existing disease — Feeling: Good · Headache, Joint pains, Muscle or body achesFree text: Headache likely due to allergies, joint pain due to pre-existing orthopedic problems.MedDRA releases: 2024-11 · check-in free text available
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2021-11-10
Survey response — day 7, dose 3MedDRA: Arthralgia, Headache, Pain, Pre-existing disease — Feeling: Good · Headache, Joint pains, Muscle or body achesFree text: Headache due allergies, joint pain & body aches due to pre-existing orthopedic problems.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-17
- 2021-11-24
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2021-12-01
Survey response — day 28, dose 3MedDRA: Headache, Oropharyngeal pain — Feeling: FairFree text: Headache & sore throatMedDRA releases: 2024-11 · check-in free text available
- 2021-12-08
- 2021-12-15
- 2022-02-02
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2022-04-27
Dose 4 — Moderna
- 2022-04-27
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2022-04-28
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2022-04-29
- 2022-04-30
- 2022-05-01
- 2022-05-02
- 2022-05-03
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
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2022-06-01
Survey response — day 35, dose 4MedDRA: Sneezing — Feeling: GoodFree text: Sneezing, constantly!MedDRA releases: 2024-11 · check-in free text available
- 2022-06-08
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2022-07-27
Survey response — 3 months, dose 4MedDRA: Asbestosis, Office visit, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I had a sinus infection. Also, I recently learned I have asbestosis due to secondary exposure. It's mildly affecting my health. · Healthcare visit (other): Doctor's appointment for the sinus infection. No necessary treatment for the asbestosis yet.MedDRA releases: 2024-11 · check-in free text available
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2022-07-27
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-07-28
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2022-07-28
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-10-26
Survey response — 6 months, dose 4MedDRA: Office visit, Pre-existing disease, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Sinusitis due to my allergies. · Healthcare visit (other): Scheduled doctor's office visit.MedDRA releases: 2024-11 · check-in free text available
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2022-10-26
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
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2022-10-28
Call successfulNot applicable - Accidental Reporting
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2023-04-27
Survey response — 12 months, dose 4MedDRA: Breast cancer, Renal cancer — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-01 | Moderna | |
| 2 | 2021-03-30 | Moderna | |
| 3 | 2021-11-03 | Moderna | No |
| 4 | 2022-04-27 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-27 | Successful 2022-07-28 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-10-26 | Successful 2022-10-28 |
Not applicable - Accidental Reporting |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Its more tenderness than pain at the injection area.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): The day after I received my 2nd vaccine I had had excessive swelling at the injection site and it was painful to move my arm. I also had a temperature of 100.8 & was nauseous the next day. The 2nd day after vaccination my temperature was lower, 99.8. No nausea and the swelling and tenderness was reduced & I was able to move my are easily. 3rd day my temperature had returned to normal and no nausea.
Release 7 — day 35, dose 1
Symptoms: Excessive pain & swelling at injection site. The next day I had a temperature and experienced nausea.
Release 8 — day 28, dose 2
Symptoms: Ive had a cold since Thursday last week.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Those selected are daily maladies I've dealt with prior to being vaccinated.
Systemic reaction (other): The joint & muscle pain are pre-existing due to orthopedic problems!
Systemic reaction (other): Due to pre-existing conditions.
Systemic reaction (other): Those checked are due to pre-existing conditions.
Systemic reaction (other): Allergies and other pre-existing orthopedic conditions.
Systemic reaction (other): Headache likely due to allergies, joint pain due to pre-existing orthopedic problems.
Release 10 — day 7, dose 3
Systemic reaction (other): Headache due allergies, joint pain & body aches due to pre-existing orthopedic problems.
Release 10 — day 28, dose 3
Symptoms: Headache & sore throat
Release 11 — day 35, dose 4
Symptoms: Sneezing, constantly!
Release 12 — 3 months, dose 4
Symptoms: I had a sinus infection. Also, I recently learned I have asbestosis due to secondary exposure. It's mildly affecting my health.
Healthcare visit (other): Doctor's appointment for the sinus infection. No necessary treatment for the asbestosis yet.
Release 12 — 6 months, dose 4
Symptoms: Sinusitis due to my allergies.
Healthcare visit (other): Scheduled doctor's office visit.
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 | Asbestosis | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Sinusitis | · | · | ✓ |
| SD | Asbestosis | · | · | ✓ |
| SD | Breast cancer | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Renal cancer | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ○ |
| SRO | Headache | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Tenderness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release