Y3T-13135-60686
5 vaccinations
5 coded responses
40 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 531 / WI
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-26
Dose 1 — Moderna
-
2021-02-27
Registered in v-safe
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
-
2021-03-12
Survey response — day 14, dose 1MedDRA: Injection site pain, Injection site pruritus, Injection site rash, Rash erythematous — Feeling: GoodFree text: Itching and red rash at injection site. Also slightly tender. Not serious. Using cortisone for the itch. Seems to help.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
-
2021-03-26
Dose 2 — Moderna
- 2021-03-26
-
2021-03-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-28
- 2021-03-29
- 2021-03-30
-
2021-03-31
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-01
- 2021-04-02
- 2021-04-09
-
2021-04-16
Survey response — day 21, dose 2MedDRA: Asthenia, Fatigue — Feeling: GoodFree text: I am fatigued most afternoons. Less energy to get things done. Not severe, just need to take naps.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
-
2021-04-30
Survey response — day 35, dose 2MedDRA: Disturbance in attention, Feeling abnormal, Headache — Feeling: FairFree text: Mild to medium head aches. Difficulty concentrating. I feel like im a little off my game. Can't explain, just don't feel normal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
- 2021-06-27
- 2021-09-25
-
2021-11-19
Dose 3 — Moderna
-
2022-03-27
Survey response — 12 months, dose 2MedDRA: Abdominal discomfort, Gastrooesophageal reflux disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sudden gastrointestinal discomfort. Horrible acid reflux. No changes in eating habits or vitamin supplementation. No change in stress level.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-27
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-03-29
-
2022-06-08
Dose 4 — Moderna
- 2022-06-08
-
2022-06-09
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fever · Chills, Headache, Muscle or body achesAdult check-in
- 2022-06-10
- 2022-06-11
- 2022-06-12
- 2022-06-13
- 2022-06-14
- 2022-06-15
- 2022-06-24
- 2022-06-29
- 2022-07-06
- 2022-07-13
- 2022-07-20
- 2022-09-09
-
2022-10-08
Dose 5 — ModernaCo-administered: Flu
-
2022-12-07
Survey response — 6 months, dose 4MedDRA: Palpitations, Ventricular extrasystoles — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Mild heart palpations, diagnosed as PVCs.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-07
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-12-08
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-12-08
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-26 | Moderna | |
| 2 | 2021-03-26 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-06-08 | Moderna | No |
| 5 | 2022-10-08 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-27 | Successful 2022-12-08 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-12-07 | Successful 2022-12-08 |
Does not wish to fill out VAERS report |
Free text
Release 5 — day 14, dose 1
Symptoms: Itching and red rash at injection site. Also slightly tender. Not serious. Using cortisone for the itch. Seems to help.
Release 7 — day 21, dose 2
Symptoms: I am fatigued most afternoons. Less energy to get things done. Not severe, just need to take naps.
Release 8 — day 35, dose 2
Symptoms: Mild to medium head aches. Difficulty concentrating. I feel like im a little off my game. Can't explain, just don't feel normal.
Release 11 — 12 months, dose 2
Symptoms: Sudden gastrointestinal discomfort. Horrible acid reflux. No changes in eating habits or vitamin supplementation. No change in stress level.
Release 12 — 6 months, dose 4
Symptoms: Mild heart palpations, diagnosed as PVCs.
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 | Abdominal discomfort | · | · | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Disturbance in attention | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Gastrooesophageal reflux disease | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Ventricular extrasystoles | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release