Y6D-10343-06436
5 vaccinations
6 coded responses
59 check-ins
5 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 117 / NY
- Registered
- 2021-02-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-17
Dose 1 — Moderna
-
2021-02-23
Registered in v-safe
- 2021-02-23
- 2021-02-24
- 2021-03-03
- 2021-03-10
-
2021-03-17
Dose 2 — Moderna
- 2021-03-17
- 2021-03-18
-
2021-03-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Fatigue or tirednessAdult check-in
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-06-16
-
2021-09-15
Survey response — 6 months, dose 2MedDRA: Hepatic enzyme increased, Hospitalisation, Nausea, Platelet count decreased, Pyrexia, SARS-CoV-2 test negative, Serum ferritin increased, Viral infection — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Acute viral syndrome that totally messed my bloodwork with low platelets, high ferritin, high liver enzymes etc. Hospital and tests. Not covid, tested 4x in 5 days. Fever, nausea. All tests negative and bloodwork normal now. July 9 thMedDRA releases: 2024-11 · check-in free text available
-
2021-09-15
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)
-
2021-09-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2021-10-25
Dose 3 — Moderna
- 2021-10-28
- 2021-10-29
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Sinus headache — Feeling: Fair · HeadacheFree text: It was like a sinus headache when I woke up but it's gone nowMedDRA releases: 2024-11 · check-in free text available
- 2021-10-31
- 2021-11-01
-
2021-11-08
Survey response — day 14, dose 3MedDRA: Arthritis, Office visit, Pain management, Pelvic fracture, Self-medication — Feeling: Poor · 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: I fractured 2 bones in my pelvis 6 weeks ago on the right side. Starting last week my sacro-illiac joint became inflamed from uneven movement on both sides of my pelvis. On steroids. Tylenol. Pain management with a shot last Wednesday. · Healthcare visit (other): Doctors, orthopedic and pain managementMedDRA releases: 2024-11 · check-in free text available
-
2021-11-08
Report sent to call center — day 14, dose 3Be 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)
-
2021-11-09
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-18
Dose 4 — Moderna
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-05-02
- 2022-05-09
- 2022-05-16
- 2022-05-23
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2022-05-30
Survey response — day 42, dose 4MedDRA: Fatigue, Medical counselling, Nasal congestion, Nausea — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Nauseous and nasal congestion for the past 5 days. Improves as the day goes on. Tired today. · Healthcare visit (other): And called my doctor leaving a message to call meMedDRA releases: 2024-11 · check-in free text available
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2022-05-30
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-06-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-07-18
Survey response — 3 months, dose 4MedDRA: Cough, Pyrexia, Respiratory tract congestion, Rhinorrhoea, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Scratchy throat, slight fever, nasal drip and congestion, slight coughMedDRA releases: 2024-11 · check-in free text available
-
2022-07-18
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
-
2022-07-19
Call successfulParticipant prefers to complete VAERS report online
-
2022-10-13
Dose 5 — Moderna
- 2022-10-13
- 2022-10-14
- 2022-10-15
- 2022-10-16
- 2022-10-17
- 2022-10-18
- 2022-10-19
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-11-12
- 2022-11-17
- 2022-11-26
-
2023-01-14
Survey response — 3 months, dose 5MedDRA: Fractured sacrum, Muscle strain, Office visit, Osteitis, Pain, Physiotherapy, Stress fracture — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-01-14
Report sent to call center — 3 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2023-01-16
- 2023-04-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-17 | Moderna | |
| 2 | 2021-03-17 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-18 | Moderna | No |
| 5 | 2022-10-13 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-09-15 | Successful 2021-09-20 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2021-11-08 | Successful 2021-11-09 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-05-30 | Successful 2022-06-01 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-07-18 | Successful 2022-07-19 |
Participant prefers to complete VAERS report online |
| 2023-01-14 | Unsuccessful |
Free text
Release 9 — 6 months, dose 2
Symptoms: Acute viral syndrome that totally messed my bloodwork with low platelets, high ferritin, high liver enzymes etc. Hospital and tests. Not covid, tested 4x in 5 days. Fever, nausea. All tests negative and bloodwork normal now. July 9 th
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): It was like a sinus headache when I woke up but it's gone now
Release 10 — day 14, dose 3
Symptoms: I fractured 2 bones in my pelvis 6 weeks ago on the right side. Starting last week my sacro-illiac joint became inflamed from uneven movement on both sides of my pelvis. On steroids. Tylenol. Pain management with a shot last Wednesday.
Healthcare visit (other): Doctors, orthopedic and pain management
Release 11 — day 42, dose 4
Symptoms: Nauseous and nasal congestion for the past 5 days. Improves as the day goes on. Tired today.
Healthcare visit (other): And called my doctor leaving a message to call me
Release 12 — 3 months, dose 4
Symptoms: Scratchy throat, slight fever, nasal drip and congestion, slight cough
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 | Medical counselling | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Pain management | · | · | ✓ |
| HCVO | Physiotherapy | · | · | ✓ |
| SD | Arthritis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Fractured sacrum | · | · | ✓ |
| SD | Hepatic enzyme increased | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Muscle strain | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Osteitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain management | · | · | ✓ |
| SD | Pelvic fracture | · | · | ✓ |
| SD | Platelet count decreased | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Serum ferritin increased | · | · | ✓ |
| SD | Stress fracture | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Sinus headache | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release