Y3M-80551-79098
3 vaccinations
3 coded responses
30 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 232 / VA
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Registered in v-safe
-
2021-01-08
Dose 1 — Moderna
-
2021-01-08
Survey response — day 0, dose 1MedDRA: Dysgeusia, Immediate post-injection reaction — Feeling: Fair · Site: Pain · Muscle or body achesFree text: Metallic taste that started 1 hour after receiving shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-09
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-10
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-11
- 2021-01-12
-
2021-01-17
Survey response — day 7, dose 1MedDRA: Injection site rash, Medical counselling — Feeling: Fair · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Rash at injection site and traveling down arm (still above elbow) · Healthcare visit (other): Spoke with pharmacist who recommended to continue tracking rash, Benadryl, and icingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-17
Report sent to call center — day 7, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-01-22
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site nodule, Injection site rash, Medical counselling, Urticaria — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Welt on arm 2 in diameter at injection site that started on day 8. Itchy. On day 9, decreased in redness but grew in size with 7 pink rash spots radiating distally from bicep to middle delt, stopping 2 above elbow. Day 10 light pink circle. · Healthcare visit (other): In person visit to CVS pharmacist on day 9. Phone call to pharmacist received vaccination from on day 10.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-22
Report sent to call center — day 14, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-29
-
2021-02-05
Dose 2 — Moderna
- 2021-02-05
-
2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-14
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-16
- 2021-03-21
-
2021-10-26
Dose 3 — Pfizer-BioNTech
- 2021-10-26
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-28
- 2021-10-29
- 2021-11-11
- 2021-11-16
- 2021-11-30
- 2021-12-07
- 2022-01-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-05 | Moderna | |
| 3 | 2021-10-26 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-09 | Unsuccessful | |
| 2021-01-17 | Unsuccessful | |
| 2021-01-22 | Unsuccessful |
Free text
Release 1 — day 0, dose 1
Systemic reaction (other): Metallic taste that started 1 hour after receiving shot
Release 2 — day 7, dose 1
Systemic reaction (other): Rash at injection site and traveling down arm (still above elbow)
Healthcare visit (other): Spoke with pharmacist who recommended to continue tracking rash, Benadryl, and icing
Release 2 — day 14, dose 1
Symptoms: Welt on arm 2 in diameter at injection site that started on day 8. Itchy. On day 9, decreased in redness but grew in size with 7 pink rash spots radiating distally from bicep to middle delt, stopping 2 above elbow. Day 10 light pink circle.
Healthcare visit (other): In person visit to CVS pharmacist on day 9. Phone call to pharmacist received vaccination from on day 10.
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 | Medical counselling | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site nodule | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release