Y3A-21678-28461
2 vaccinations
5 coded responses
18 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 070 / NJ
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Registered in v-safe
-
2021-01-05
Dose 1 — Moderna
- 2021-01-05
-
2021-01-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-14
- 2021-01-19
- 2021-01-26
- 2021-02-03
-
2021-02-06
Dose 2 — Moderna
-
2021-02-23
Survey response — day 14, dose 2MedDRA: Chills, Myalgia — Feeling: Good · Be unable to do your normal daily activitiesFree text: The day after receiving the 2nd vaccine i felt chills and muscle pain .MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
-
2021-03-06
Survey response — day 28, dose 2MedDRA: Chest pain — Feeling: FairFree text: Somewhat of a muscle aches in my chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Survey response — day 35, dose 2MedDRA: Headache, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Headaches · Healthcare visit (other): Doctor visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-20
-
2021-05-12
Survey response — 3 months, dose 2MedDRA: Breast mass, Menstruation irregular — Feeling: GoodFree text: At some point I some knots in my chest... specifically in my right breast.I also experienced a change in be my menstrual flow... after almost a year of not having ... it started back up after receiving the COVID vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-09
Survey response — 6 months, dose 2MedDRA: Heavy menstrual bleeding — Feeling: Good · Be unable to do your normal daily activitiesFree text: Heavy menstrual cycles to the point of going through super/ overnight padsMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-12-17
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-06 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-13 | Successful 2021-12-17 |
Participant prefers to complete VAERS report online |
Free text
Release 4 — day 14, dose 2
Symptoms: The day after receiving the 2nd vaccine i felt chills and muscle pain .
Release 5 — day 28, dose 2
Symptoms: Somewhat of a muscle aches in my chest
Release 5 — day 35, dose 2
Release 8 — 3 months, dose 2
Symptoms: At some point I some knots in my chest... specifically in my right breast.I also experienced a change in be my menstrual flow... after almost a year of not having ... it started back up after receiving the COVID vaccine.
Release 9 — 6 months, dose 2
Symptoms: Heavy menstrual cycles to the point of going through super/ overnight pads
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 | Breast mass | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Heavy menstrual bleeding | ✓ | · | ✓ |
| SD | Menstruation irregular | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release