Y47-14675-00894
4 vaccinations
4 coded responses
45 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 495 / MI
- Registered
- 2021-03-26
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-05
Dose 1 — Moderna
-
2021-03-26
Registered in v-safe
- 2021-03-26
-
2021-04-02
Dose 2 — Moderna
-
2021-04-02
Health check-in — day 0, dose 2Feeling: Poor · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-07
- 2021-04-08
- 2021-04-09
-
2021-04-16
Survey response — day 14, dose 2MedDRA: Chills, Dyspnoea, Fatigue, Headache, Myalgia, Pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Headache, body chills, muscle aches, shortness of breathe/labored breathing, tiredness and fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-07-04
- 2021-10-01
- 2021-12-21
-
2022-04-02
Survey response — 12 months, dose 2MedDRA: Cataract — Feeling: GoodFree text: Cataracts. Both eyes scheduled for surgery in April.MedDRA releases: 2024-11 · check-in free text available
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2022-10-31
Dose 3 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-31
- 2022-11-01
- 2022-11-02
- 2022-11-03
- 2022-11-04
- 2022-11-05
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2022-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Rash — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection siteFree text: I have had the painful rash the past 4 days. But i thought it was because of a new chain I started wearing. So I took the chain off two days ago but the painful rash is still there in my lower neck and back area. Symptoms have not gone away and it isMedDRA releases: 2024-11 · check-in free text available
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2022-11-07
Survey response — day 7, dose 3MedDRA: Rash — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection siteFree text: The rash area seems to be getting better today and nit as painful.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-14
- 2022-11-21
- 2022-11-28
- 2022-12-05
- 2022-12-12
- 2023-02-01
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2023-03-29
Dose 4 — Moderna
- 2023-03-29
- 2023-03-30
- 2023-03-31
- 2023-04-01
- 2023-04-02
- 2023-04-03
- 2023-04-04
- 2023-04-05
- 2023-04-12
- 2023-04-19
- 2023-04-26
- 2023-05-03
- 2023-05-10
- 2023-06-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna | |
| 3 | 2022-10-31 | Pfizer-BioNTech | Flu |
| 4 | 2023-03-29 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-16 | Unsuccessful |
Free text
Release 7 — day 14, dose 2
Symptoms: Headache, body chills, muscle aches, shortness of breathe/labored breathing, tiredness and fatigue
Release 11 — 12 months, dose 2
Symptoms: Cataracts. Both eyes scheduled for surgery in April.
Release 12 — days 1–6 daily, dose 3
Systemic reaction (other): I have had the painful rash the past 4 days. But i thought it was because of a new chain I started wearing. So I took the chain off two days ago but the painful rash is still there in my lower neck and back area. Symptoms have not gone away and it is cut off by CDC
Release 12 — day 7, dose 3
Systemic reaction (other): The rash area seems to be getting better today and nit as painful.
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 | Cataract | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SRO | Rash | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release