Y7J-21538-50628
3 vaccinations
5 coded responses
39 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 606 / IL
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-18
Registered in v-safe
-
2021-03-18
Dose 1 — Moderna
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
-
2021-03-23
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: GoodFree text: I am sure that this is NOT related to the vaccine but when I tried to donate blood today, I had low iron; just reporting in the interests of "more data" is a good thing. As I said I'm sure it's not related.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-25
-
2021-04-01
Survey response — day 14, dose 1MedDRA: Headache — Feeling: FairFree text: I don't think this is related to the vaccine, but I have developed a persistent sub occipital headache on the opposite side of my body from the shot (shot on the left, headache is on the right).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-08
-
2021-04-15
Dose 2 — Moderna
- 2021-04-15
-
2021-04-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Chills, Fatigue or tirednessAdult check-in
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
-
2021-07-15
Survey response — 3 months, dose 2MedDRA: Nasal congestion, Oropharyngeal pain, Parainfluenzae virus infection, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activitiesFree text: Sore throat, nasal congestion. Negative COVID test. Probably parainfluenzaMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-14
Survey response — 6 months, dose 2MedDRA: Cough, Fatigue, Nasal congestion, Pain — 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 visitFree text: Cough, aches, fatigue, nasal congestionMedDRA releases: 2024-11 · check-in free text available
-
2021-10-14
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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-19
- 2021-10-22
-
2021-11-17
Dose 3 — Moderna
- 2021-11-17
-
2021-11-18
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-21
- 2021-11-22
- 2021-11-23
- 2021-11-24
- 2021-12-03
- 2021-12-09
- 2021-12-15
- 2021-12-22
- 2021-12-29
- 2022-02-16
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2022-05-18
Survey response — 6 months, dose 3MedDRA: Coeliac disease, Colitis microscopic — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I was diagnosed with celiac disease and microscopic colitis; obviously not related to the vaccines, but I am simply reporting an unusual, late-in-life diagnosis in the interests of providing more information, rather than less.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-18
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-05-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-15 | Moderna | |
| 3 | 2021-11-17 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-14 | Successful 2022-05-19 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-05-18 | Successful 2022-05-19 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): I am sure that this is NOT related to the vaccine but when I tried to donate blood today, I had low iron; just reporting in the interests of "more data" is a good thing. As I said I'm sure it's not related.
Release 6 — day 14, dose 1
Symptoms: I don't think this is related to the vaccine, but I have developed a persistent sub occipital headache on the opposite side of my body from the shot (shot on the left, headache is on the right).
Release 9 — 3 months, dose 2
Symptoms: Sore throat, nasal congestion. Negative COVID test. Probably parainfluenza
Release 10 — 6 months, dose 2
Symptoms: Cough, aches, fatigue, nasal congestion
Release 11 — 6 months, dose 3
Symptoms: I was diagnosed with celiac disease and microscopic colitis; obviously not related to the vaccines, but I am simply reporting an unusual, late-in-life diagnosis in the interests of providing more information, rather than less.
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 | Coeliac disease | · | · | ✓ |
| SD | Colitis microscopic | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Parainfluenzae virus infection | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release