Y3L-30970-19203
3 vaccinations
5 coded responses
28 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 972 / OR
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Dose 1 — Moderna
-
2021-01-26
Registered in v-safe
-
2021-01-26
Health check-in — day 7, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · HeadacheAdult check-in
- 2021-01-29
-
2021-02-06
Survey response — day 21, dose 1MedDRA: Injection site erythema, Injection site pain, Injection site warmth — Feeling: FairFree text: Over a week layer it got red,hot and sore over outside of injection armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-11
Survey response — day 28, dose 1MedDRA: Arthralgia, Erythema, Limb discomfort, Pain, Pruritus, Swelling — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Redness and swelling on upper arm and itching all of which comes and goes. Pain and heaviness and jt painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-16
Dose 2 — Moderna
- 2021-02-18
- 2021-02-19
- 2021-02-24
- 2021-03-02
- 2021-03-10
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-17
-
2021-10-27
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain, Redness, Swelling · HeadacheFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
- 2021-10-31
- 2021-11-02
- 2021-11-03
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
-
2022-01-26
Survey response — 3 months, dose 3MedDRA: Apnoea, Blood sodium decreased, Chest X-ray abnormal, Cough, Dyspnoea, Headache, Nausea, Periorbital swelling, Platelet count increased, White blood cell count increased — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Cough, ^T, ^HR, dyspnea, apneic episodes, O2sat 90-95%, bilateral periorbital swelling, HA , nausea, wbc>12, High platelets, borderline low Na+, possible retrocardiac density on the left by chest X-ray unexplored by her medical team, 1/18-to presentMedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
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 · Emergency room or emergency department visit · 1 call case(s)
- 2022-01-27
-
2022-04-28
Survey response — 6 months, dose 3MedDRA: Nausea, Unevaluable event, Vomiting — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Upper respiratory, n&vMedDRA releases: 2024-11 · check-in free text available
- 2022-10-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-26 | Unsuccessful |
Free text
Release 3 — day 21, dose 1
Symptoms: Over a week layer it got red,hot and sore over outside of injection arm
Release 4 — day 28, dose 1
Symptoms: Redness and swelling on upper arm and itching all of which comes and goes. Pain and heaviness and jt pain
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sore throat
Release 11 — 3 months, dose 3
Symptoms: Cough, ^T, ^HR, dyspnea, apneic episodes, O2sat 90-95%, bilateral periorbital swelling, HA , nausea, wbc>12, High platelets, borderline low Na+, possible retrocardiac density on the left by chest X-ray unexplored by her medical team, 1/18-to present cut off by CDC
Release 11 — 6 months, dose 3
Symptoms: Upper respiratory, n&v
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 |
|---|---|---|---|---|
| SD | Apnoea | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Blood sodium decreased | · | · | ✓ |
| SD | Chest X-ray abnormal | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
| SD | Limb discomfort | ✓ | ✓ | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Periorbital swelling | · | · | ✓ |
| SD | Platelet count increased | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Swelling | ✓ | ✓ | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SD | White blood cell count increased | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release