Y6W-17503-48702
1 vaccination
6 coded responses
9 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 933 / CA
- Registered
- 2021-03-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-12
Dose 1 — Moderna
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2021-03-14
Registered in v-safe
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2021-03-14
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-03-15
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Palpitations, Respiratory tract congestion — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: Dizzy, head congestion, heart palpitationsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Anxiety, Injection site paraesthesia, Palpitations, Restlessness — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Tingling where vaccine was administered. Anxiousness and restlessness, heart palpitationsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-03-19
Survey response — day 7, dose 1MedDRA: Dysgeusia, Gastrointestinal disorder, Olfactory dysfunction, Parosmia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activitiesFree text: Taste buds are distinctly different. Olfactory is different when eating certain foods I smell and taste cigarettes smoke. Different points in the day I smell beer/gasoline. My bowel movements and gas smells like burning plasticMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-26
Survey response — day 14, dose 1MedDRA: Headache, Nausea, Photopsia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Severe headache and nauseous. Seeing stars.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-26
Report sent to call center — day 14, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-02
Survey response — day 21, dose 1MedDRA: Constipation, Headache, Nausea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Throbbing headache ConstipationNauseous.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Report sent to call center — day 21, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-06-13
Survey response — 3 months, dose 1MedDRA: Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Fatigue, weight gain, forgetting and nauseousMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-26 | Unsuccessful | |
| 2021-04-02 | Unsuccessful |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Dizzy, head congestion, heart palpitations
Systemic reaction (other): Tingling where vaccine was administered. Anxiousness and restlessness, heart palpitations
Release 5 — day 7, dose 1
Systemic reaction (other): Taste buds are distinctly different. Olfactory is different when eating certain foods I smell and taste cigarettes smoke. Different points in the day I smell beer/gasoline. My bowel movements and gas smells like burning plastic
Release 6 — day 14, dose 1
Symptoms: Severe headache and nauseous. Seeing stars.
Release 6 — day 21, dose 1
Symptoms: Throbbing headache ConstipationNauseous.
Release 9 — 3 months, dose 1
Symptoms: Fatigue, weight gain, forgetting and nauseous
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 | Constipation | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Photopsia | ✓ | ✓ | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SRO | Injection site paraesthesia | ✓ | ✓ | ✓ |
| SRO | Olfactory dysfunction | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Parosmia | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Restlessness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release