Y4D-16176-68077
5 vaccinations
8 coded responses
67 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 430 / OH
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Registered in v-safe
-
2020-12-30
Dose 1 — Moderna
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-06
- 2021-01-13
-
2021-01-20
Survey response — day 21, dose 1MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: GoodFree text: Sore throat, no fever, slight congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-27
Dose 2 — Moderna
- 2021-01-27
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-29
Survey response — days 1–6 daily, dose 2MedDRA: Erythema, Peripheral swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Fatigue or tirednessFree text: Arm erythema is 8.5cm x 6.5 cm with swelling in the same area.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
-
2021-01-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-04-28
- 2021-07-28
-
2021-11-02
Dose 3 — Moderna
- 2021-11-02
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-11-04
- 2021-11-05
-
2021-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Pharyngitis streptococcal — Feeling: FairFree text: Unrelated to vaccine-I have strep throat.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain, Pharyngitis streptococcal — Feeling: GoodFree text: I have strep throat so my sore throat is unrelated to the vaccine.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-08
Survey response — days 1–6 daily, dose 3MedDRA: Pharyngitis streptococcal — Feeling: Good · Fatigue or tirednessFree text: Symptoms more likely related to strep throat.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-11
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-14
- 2022-02-01
- 2022-05-03
-
2022-05-19
Dose 4 — Moderna
- 2022-05-19
- 2022-05-20
-
2022-05-21
Survey response — days 1–6 daily, dose 4MedDRA: Adverse reaction, Injection site pain — Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: These symptoms occurred yesterday after my last check in. They are better now. Just having mild tenderness at injection site today.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-22
- 2022-05-23
- 2022-05-24
- 2022-05-25
- 2022-05-26
- 2022-06-02
- 2022-06-09
-
2022-06-16
Survey response — day 28, dose 4MedDRA: Oedema peripheral, Peripheral swelling — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Leg swelling of unknown etiology. Physical exam within normal limits except for bilateral pedal edema.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-16
Report sent to call center — day 28, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-06-17
-
2022-06-22
Call successfulCompleted over the phone
- 2022-06-23
- 2022-06-30
- 2022-08-18
-
2022-09-14
Dose 5 — Moderna
- 2022-09-14
- 2022-09-16
- 2022-09-17
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-28
-
2022-10-05
Survey response — day 21, dose 5MedDRA: Condition aggravated, Emergency care, Pre-existing disease, Tachyarrhythmia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: I believe this is unrelated to the COVID vaccine. I was hiking in the mountains last week at 10000-11000 feet elevation and then at 4-5000 feet. My known arrhythmia started. It is back to normal now. · Healthcare visit (other): EMS came to do ekg due to tachyarrhythmia.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-05
Report sent to call center — day 21, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-10-06
- 2022-10-12
-
2022-10-12
Call successfulCompleted over the phone
- 2022-10-19
- 2022-10-26
- 2022-12-14
- 2023-03-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-27 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-05-19 | Moderna | No |
| 5 | 2022-09-14 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-16 | Successful 2022-06-22 |
Completed over the phone |
| 2022-10-05 | Successful 2022-10-12 |
Completed over the phone |
Free text
Release 2 — day 21, dose 1
Symptoms: Sore throat, no fever, slight congestion
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Arm erythema is 8.5cm x 6.5 cm with swelling in the same area.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Unrelated to vaccine-I have strep throat.
Systemic reaction (other): I have strep throat so my sore throat is unrelated to the vaccine.
Systemic reaction (other): Symptoms more likely related to strep throat.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): These symptoms occurred yesterday after my last check in. They are better now. Just having mild tenderness at injection site today.
Release 12 — day 28, dose 4
Symptoms: Leg swelling of unknown etiology. Physical exam within normal limits except for bilateral pedal edema.
Release 12 — day 21, dose 5
Symptoms: I believe this is unrelated to the COVID vaccine. I was hiking in the mountains last week at 10000-11000 feet elevation and then at 4-5000 feet. My known arrhythmia started. It is back to normal now.
Healthcare visit (other): EMS came to do ekg due to tachyarrhythmia.
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 | Emergency care | · | · | ✓ |
| HCVO | Pre-existing disease | · | · | ✓ |
| HCVO | Tachyarrhythmia | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Oedema peripheral | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Pharyngitis streptococcal | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release