Y62-23122-34035
3 vaccinations
4 coded responses
29 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 195 / PA
- Registered
- 2021-04-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-28
Registered in v-safe
-
2021-04-28
Dose 1 — Moderna
- 2021-04-28
- 2021-04-29
- 2021-04-30
- 2021-05-01
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-12
- 2021-05-19
-
2021-05-26
Survey response — day 28, dose 1MedDRA: Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I sometimes suffer from bronchitis during allergy season. I started with bronchial symptoms late Monday. No fever. I rescheduled my 2 vaccination until this has passed.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-26
Report sent to call center — day 28, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-02
Dose 2 — Moderna
-
2021-06-02
Survey response — day 0, dose 2MedDRA: Bronchitis, Condition aggravated, Pre-existing disease — Feeling: GoodFree text: Got vacc 2 hrs ago. Had bronchitis between doses - was 10x worse than ever b4. Fever of 100! Usually bronchitis no problem.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-06-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-06-05
- 2021-06-06
- 2021-06-07
- 2021-06-08
- 2021-06-09
- 2021-06-17
-
2021-06-23
Survey response — day 21, dose 2MedDRA: Chills — Feeling: GoodFree text: Sometimes I get random chills. At least one day a week. But I cant be sure if it has anything to do with the vaccine or the weather. My temperature reads as normal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-30
- 2021-07-07
- 2021-07-14
- 2021-09-01
-
2021-12-01
Survey response — 6 months, dose 2MedDRA: Phantom limb syndrome — Feeling: GoodFree text: I've got this weird phantom pain in my left leg. Can't say that it has anything to do with anything but it's only been around for maybe the last two months.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-12
Dose 3 — Moderna
- 2022-04-27
- 2022-05-16
- 2022-08-13
- 2023-02-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-28 | Moderna | |
| 2 | 2021-06-02 | Moderna | |
| 3 | 2022-02-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-26 | Unsuccessful |
Free text
Release 8 — day 28, dose 1
Symptoms: I sometimes suffer from bronchitis during allergy season. I started with bronchial symptoms late Monday. No fever. I rescheduled my 2 vaccination until this has passed.
Release 8 — day 0, dose 2
Systemic reaction (other): Got vacc 2 hrs ago. Had bronchitis between doses - was 10x worse than ever b4. Fever of 100! Usually bronchitis no problem.
Release 9 — day 21, dose 2
Symptoms: Sometimes I get random chills. At least one day a week. But I cant be sure if it has anything to do with the vaccine or the weather. My temperature reads as normal.
Release 10 — 6 months, dose 2
Symptoms: I've got this weird phantom pain in my left leg. Can't say that it has anything to do with anything but it's only been around for maybe the last two months.
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 | Chills | ✓ | ✓ | ✓ |
| SD | Phantom limb syndrome | · | · | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Bronchitis | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release