Y49-24853-05095
3 vaccinations
6 coded responses
33 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 442 / OH
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-04
Registered in v-safe
-
2021-02-04
Dose 1 — Moderna
- 2021-02-04
- 2021-02-05
-
2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: I did get 2 notices that I would no longer receive these notifications.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
-
2021-03-11
Dose 2 — Moderna
- 2021-03-11
- 2021-03-12
-
2021-03-13
Survey response — days 1–6 daily, dose 2MedDRA: Injection site rash, Injection site warmth — Feeling: Good · Site: Pain, Redness, SwellingFree text: Rash is hot. Crazy thing it is about an inch below the injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Injection site rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Rash still I inch below the site 2x1MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Survey response — days 1–6 daily, dose 2MedDRA: Injection site rash — Feeling: GoodFree text: My rash is gone that I got 1 inch below my injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-17
-
2021-03-18
Survey response — day 7, dose 2MedDRA: Pruritus, Rash — Feeling: Good · Site: ItchingFree text: Rash left yesterday, itching started today but there is no rash with itMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-06-11
- 2021-09-09
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2022-03-11
Survey response — 12 months, dose 2MedDRA: Bronchitis, Office visit, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Mild sore throat. Later bronchitis. Had a quick and long Covid test. Both negative. Time: Christmas week. Fine after 10 days · Healthcare visit (other): 2 different out patient hospital clinicsMedDRA releases: 2024-11 · check-in free text available
-
2022-03-11
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-03-14
-
2022-03-14
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-07-14
Dose 3 — Moderna
- 2022-07-14
- 2022-07-15
- 2022-07-16
- 2022-07-17
- 2022-07-18
- 2022-07-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-11 | Moderna | |
| 3 | 2022-07-14 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-11 | Successful 2022-03-14 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): I did get 2 notices that I would no longer receive these notifications.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Rash is hot. Crazy thing it is about an inch below the injection site.
Systemic reaction (other): Rash still I inch below the site 2x1
Systemic reaction (other): My rash is gone that I got 1 inch below my injection site
Release 5 — day 7, dose 2
Systemic reaction (other): Rash left yesterday, itching started today but there is no rash with it
Release 11 — 12 months, dose 2
Symptoms: Mild sore throat. Later bronchitis. Had a quick and long Covid test. Both negative. Time: Christmas week. Fine after 10 days
Healthcare visit (other): 2 different out patient hospital clinics
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 | · | · | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release