Y63-21218-40468
2 vaccinations
2 coded responses
12 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 836 / ID
- Registered
- 2021-03-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Dose 1 — Moderna
-
2021-02-26
Dose 2 — Moderna
-
2021-03-01
Registered in v-safe
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
-
2021-03-01
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Feeling hot, Malaise, Peripheral swelling, Rash — Feeling: Good · Site: Redness, Itching · HeadacheFree text: I actually got my shot last Friday but nobody told me to register with this health report. Saturday I was really sick but no fever and no cough but all the other symptoms. Sunday still sick and fatigued but not as bad and the rash and heat and swelling all over my arm where I received the injection was quite bad. Today is the first day that I was seeing some relief after visiting with my doctor yesterday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · Headache, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-04
- 2021-03-05
-
2021-03-13
Survey response — day 14, dose 2MedDRA: Arthralgia, Headache — Feeling: FairFree text: Massive headache and 3 days of joint pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
- 2021-03-28
- 2021-04-02
- 2021-04-09
- 2021-05-31
- 2021-08-30
- 2021-09-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Moderna | |
| 2 | 2021-02-26 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-01 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): I actually got my shot last Friday but nobody told me to register with this health report. Saturday I was really sick but no fever and no cough but all the other symptoms. Sunday still sick and fatigued but not as bad and the rash and heat and swelling all over my arm where I received the injection was quite bad. Today is the first day that I was seeing some relief after visiting with my doctor yesterday.
Release 5 — day 14, dose 2
Symptoms: Massive headache and 3 days of joint pain.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release