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Y5V-13788-25722

3 vaccinations 4 coded responses 17 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
105 / NY
Registered
2021-03-25
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-24
    Dose 1 — Moderna
  2. 2021-03-24
    Dose 2 — Moderna
  3. 2021-03-25
    Registered in v-safe
  4. 2021-03-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  5. 2021-03-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Diarrhea · Be unable to work
    Adult check-in
  6. 2021-03-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work
    Adult check-in
  7. 2021-03-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Itching · Fever · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  8. 2021-03-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness · Be unable to work
    Adult check-in
  9. 2021-03-30
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work
    Adult check-in
  10. 2021-03-31
    Health check-in — day 7, dose 2
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  11. 2021-04-07
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  12. 2021-04-14
    Survey response — day 21, dose 2
    MedDRA: Emergency care, Hypotension — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: blood pressure of 68/44 that remained low for over an hour. issue resolved in ER, but cause is still unknown
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-04-14
    Report sent to call center — day 21, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  14. 2021-04-21
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  15. 2021-04-28
    Survey response — day 35, dose 2
    MedDRA: Fatigue, Malaise — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities
    Free text: I continue to be fatigued and when I try to increase my activity I feel ill.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-05-05
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  17. 2021-06-24
    Survey response — 3 months, dose 2
    MedDRA: Fatigue, Neurological symptom, Office visit, Transient ischaemic attack — Feeling: Fair · Be unable to do your normal daily activities
    Free text: I continue to have bouts of fatigue and some neurological symptoms. My Drs at NYU have thought the TIA I had after my first shot was coincidental to the vaccine but they have no real way of knowing for sure.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-09-22
    Survey response — 6 months, dose 2
    MedDRA: Liver function test abnormal, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: liver function blood tests are abnormal · Healthcare visit (other): dr visit in person
    MedDRA releases: 2024-11 · check-in free text available
  19. 2021-09-22
    Report sent to call center — 6 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    1 call case(s)
  20. 2021-09-22
  21. 2021-11-26
    Dose 3 — Moderna
  22. 2022-03-26
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in
  23. 2022-05-27
    Health check-in — 6 months, dose 3
    Feeling: Fair
    Adult check-in
  24. 2022-11-26
    Health check-in — 12 months, dose 3
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-24Moderna
22021-03-24Moderna
32021-11-26Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-04-14 Unsuccessful
2021-09-22 Unsuccessful

Free text

Release 7 — day 21, dose 2

2021-04-14

Symptoms: blood pressure of 68/44 that remained low for over an hour. issue resolved in ER, but cause is still unknown

Release 8 — day 35, dose 2

2021-04-28

Symptoms: I continue to be fatigued and when I try to increase my activity I feel ill.

Release 9 — 3 months, dose 2

2021-06-24

Symptoms: I continue to have bouts of fatigue and some neurological symptoms. My Drs at NYU have thought the TIA I had after my first shot was coincidental to the vaccine but they have no real way of knowing for sure.

Release 9 — 6 months, dose 2

2021-09-22

Symptoms: liver function blood tests are abnormal
Healthcare visit (other): dr visit in person

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
SDEmergency care ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHypotension ✓ ✓ ✓
SDLiver function test abnormal · · ✓
SDMalaise ✓ ✓ ✓
SDNeurological symptom ✓ ✓ ✓
SDOffice visit ✓ ✓ ✓
SDTransient ischaemic attack ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release