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
-
2021-02-24
Dose 1 — Moderna
-
2021-03-24
Dose 2 — Moderna
-
2021-03-25
Registered in v-safe
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2021-03-25
Health check-in — days 1–6 daily, dose 2Feeling: 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 activitiesAdult check-in
-
2021-03-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Diarrhea · Be unable to workAdult check-in
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2021-03-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to workAdult check-in
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2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Itching · Fever · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-03-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness · Be unable to workAdult check-in
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2021-03-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-03-31
- 2021-04-07
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2021-04-14
Survey response — day 21, dose 2MedDRA: 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 visitFree text: blood pressure of 68/44 that remained low for over an hour. issue resolved in ER, but cause is still unknownMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Report sent to call center — day 21, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-21
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2021-04-28
Survey response — day 35, dose 2MedDRA: Fatigue, Malaise — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree 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
- 2021-05-05
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2021-06-24
Survey response — 3 months, dose 2MedDRA: Fatigue, Neurological symptom, Office visit, Transient ischaemic attack — Feeling: Fair · Be unable to do your normal daily activitiesFree 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
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2021-09-22
Survey response — 6 months, dose 2MedDRA: 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 professionalFree text: Symptoms: liver function blood tests are abnormal · Healthcare visit (other): dr visit in personMedDRA releases: 2024-11 · check-in free text available
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2021-09-22
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-09-22
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2021-11-26
Dose 3 — Moderna
- 2022-03-26
- 2022-05-27
- 2022-11-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-24 | Moderna | |
| 2 | 2021-03-24 | Moderna | |
| 3 | 2021-11-26 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-14 | Unsuccessful | |
| 2021-09-22 | Unsuccessful |
Free text
Release 7 — day 21, dose 2
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
Symptoms: I continue to be fatigued and when I try to increase my activity I feel ill.
Release 9 — 3 months, dose 2
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hypotension | ✓ | ✓ | ✓ |
| SD | Liver function test abnormal | · | · | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Neurological symptom | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Transient ischaemic attack | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release