Y3C-30828-54014
2 vaccinations
4 coded responses
24 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 971 / OR
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Dose 1 — Moderna
-
2020-12-31
Registered in v-safe
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-06
-
2021-01-15
Survey response — day 14, dose 1MedDRA: Abdominal pain, Diarrhoea, Nausea — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Abdominal cramps, diarrhea, nausea. My daughter had the same symptoms 1 week before, she has not had a vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-15
Report sent to call center — day 14, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
- 2021-01-20
-
2021-01-27
Dose 2 — Moderna
- 2021-01-27
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-29
Survey response — days 1–6 daily, dose 2MedDRA: Vertigo — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: VertigoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-31
-
2021-02-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-02
- 2021-02-03
-
2021-02-10
Survey response — day 14, dose 2MedDRA: Eye pain, Facial discomfort, Herpes zoster, Periorbital swelling — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Beginning symptoms of shingles in left sinus: pain/tenderness over inner left eyebrow, incessant itching of left forehead, slight puffiness over left inner upper eyelid.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-10
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-04-30
- 2021-06-01
-
2022-01-29
Survey response — 12 months, dose 2MedDRA: Deafness unilateral, Herpes zoster, Labyrinthitis, Office visit, Physiotherapy, Tinnitus, Vertigo — 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 professionalFree text: Symptoms: One month after 2nd Moderna vaccine I developed shingles in left sinus despite having shingrix vaccine the previous year. In August I experienced 2nd case of labrynthitis causing vertigo and increased tinnitus with loss of hearing in right ear. · Healthcare visit (other): ENT provider visits and physical therapy visitsMedDRA releases: 2024-11 · check-in free text available
-
2022-01-29
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2022-01-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-27 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-15 | priority 2/3 | |
| 2021-02-10 | Unsuccessful | |
| 2022-01-29 | Unsuccessful |
Free text
Release 2 — day 14, dose 1
Symptoms: Abdominal cramps, diarrhea, nausea. My daughter had the same symptoms 1 week before, she has not had a vaccine.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Vertigo
Release 4 — day 14, dose 2
Symptoms: Beginning symptoms of shingles in left sinus: pain/tenderness over inner left eyebrow, incessant itching of left forehead, slight puffiness over left inner upper eyelid.
Release 11 — 12 months, dose 2
Symptoms: One month after 2nd Moderna vaccine I developed shingles in left sinus despite having shingrix vaccine the previous year. In August I experienced 2nd case of labrynthitis causing vertigo and increased tinnitus with loss of hearing in right ear.
Healthcare visit (other): ENT provider visits and physical therapy visits
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 | · | · | ✓ |
| HCVO | Physiotherapy | · | · | ✓ |
| SD | Abdominal pain | ✓ | ✓ | ✓ |
| SD | Deafness unilateral | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Eye pain | ✓ | ✓ | ✓ |
| SD | Facial discomfort | ✓ | ✓ | ✓ |
| SD | Herpes zoster | ✓ | ✓ | ✓ |
| SD | Labyrinthitis | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Periorbital swelling | ✓ | ✓ | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SD | Vertigo | · | · | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release