Y79-22466-38855
5 vaccinations
7 coded responses
47 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 142 / NY
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-16
Registered in v-safe
-
2021-01-16
Dose 1 — Moderna
- 2021-01-16
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-17
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-18
-
2021-01-19
Survey response — days 1–6 daily, dose 1MedDRA: Herpes simplex, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Small area of herpes on left side of the neck · Healthcare visit (other): Phone call for a script for acylovirMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-19
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-01-22
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-23
Survey response — day 7, dose 1MedDRA: Dizziness — Feeling: GoodFree text: Dizziness. Like what you experience when coming off an antidepressant. Not sure connected but have not had them since going off effexor 15 years ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-30
Survey response — day 14, dose 1MedDRA: Headache — Feeling: Fair · Be unable to workFree text: Continuous headachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-06
-
2021-02-13
Dose 2 — Moderna
- 2021-02-13
-
2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Chills, Headache, Muscle or body achesAdult check-in
- 2021-02-15
- 2021-02-16
-
2021-02-17
Survey response — days 1–6 daily, dose 2MedDRA: Herpes zoster — Feeling: FairFree text: Shingles for the second time. Got shingles two days after first vaccine. Second vaccine I got them three days after the injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-18
Survey response — days 1–6 daily, dose 2MedDRA: Herpes zoster — Feeling: Good · HeadacheFree text: Continue to have shinglesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Herpes zoster — Feeling: GoodFree text: ShinglesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-25
- 2021-03-27
- 2021-05-15
- 2021-08-14
-
2021-11-05
Dose 3 — Moderna
- 2022-02-13
- 2022-05-08
-
2022-06-03
Dose 4 — Moderna
- 2022-06-03
-
2022-06-04
Survey response — days 1–6 daily, dose 4MedDRA: Dizziness, Electric shock sensation — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Dizziness with brain zapsMedDRA releases: 2024-11 · check-in free text available
- 2022-06-05
- 2022-06-06
- 2022-06-07
- 2022-06-08
- 2022-06-09
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-01
- 2022-07-08
- 2022-07-15
- 2022-09-02
-
2022-10-08
Dose 5 — Moderna
- 2022-10-19
- 2022-10-22
- 2022-10-29
- 2022-11-05
- 2022-11-12
- 2022-11-19
- 2023-01-07
- 2023-04-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-13 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-06-03 | Moderna | No |
| 5 | 2022-10-08 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-17 | Unsuccessful | |
| 2021-01-19 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Small area of herpes on left side of the neck
Healthcare visit (other): Phone call for a script for acylovir
Release 2 — day 7, dose 1
Systemic reaction (other): Dizziness. Like what you experience when coming off an antidepressant. Not sure connected but have not had them since going off effexor 15 years ago.
Release 3 — day 14, dose 1
Symptoms: Continuous headaches
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Shingles for the second time. Got shingles two days after first vaccine. Second vaccine I got them three days after the injection.
Systemic reaction (other): Continue to have shingles
Systemic reaction (other): Shingles
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Dizziness with brain zaps
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Electric shock sensation | · | · | ✓ |
| SRO | Herpes simplex | ✓ | ✓ | ✓ |
| SRO | Herpes zoster | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release