Y8U-24596-88538
4 vaccinations
7 coded responses
54 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 300 / GA
- Registered
- 2021-03-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-30
Registered in v-safe
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2021-03-30
Dose 1 — Moderna
- 2021-03-30
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2021-03-31
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
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2021-04-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-13
- 2021-04-20
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2021-04-27
Dose 2 — Moderna
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2021-04-27
Survey response — day 0, dose 2MedDRA: Condition aggravated, Pre-existing disease, Visual impairment — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: vision is extremely skewed. I have Fuchs Dystrophy and a 32 QED monitor for work that I struggled to see. The corneal degeneration symptom did no occur with the 1st Vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
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2021-04-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-04-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-05-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
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2021-05-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-05-04
Survey response — day 7, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-06-08
- 2021-07-27
- 2021-10-28
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2022-01-11
Dose 3 — Moderna
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2022-01-11
Health check-in — day 0, dose 3Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-01-12
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-01-13
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
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2022-01-14
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
- 2022-01-15
- 2022-01-16
- 2022-01-17
- 2022-01-18
- 2022-01-25
- 2022-02-01
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2022-02-08
Survey response — day 28, dose 3MedDRA: Chills, Headache, Influenza, Influenza A virus test negative, Influenza B virus test positive, Influenza virus test negative, Medical counselling, Pain, Pyrexia, SARS-CoV-2 test negative — 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: Flu symptoms-fever, body aches headache, chills Fu B+ on Fri., 2/4 rapid test. Then negative COVID, Flu A & B PCR results. I've had positive Flu B tests 5/1/20 and 3/17/21, even though I have flu shot yearly. · Healthcare visit (other): Primary Care Office Nurse Practitioner VisirMedDRA releases: 2024-11 · check-in free text available
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2022-02-08
Report sent to call center — day 28, 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)
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2022-02-17
Survey response — day 35, dose 3MedDRA: Eye irritation, Fatigue, Influenza A virus test positive, Influenza B virus test positive, Medical counselling, Office visit, Pyrexia, SARS-CoV-2 test negative — 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: Continue low grade fever since 1/31 - dx Flu B (2/3) and then Flu A (2/11) - both rapid. The fatigue and eyes burning are ridiculous. However 2 Negative COVID PCRs (2/3 @ CVS - and 2/4 @ Dr office). · Healthcare visit (other): PCP Office VisitsMedDRA releases: 2024-11 · check-in free text available
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2022-02-17
Report sent to call center — day 35, 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)
- 2022-02-18
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2022-02-21
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-02-22
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2022-04-14
Survey response — 3 months, dose 3MedDRA: Acute sinusitis, Bronchitis, Laryngitis — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Acute sinusitis, Acute bronchitis and Laryngitis (Dr 3/25) and RxMedDRA releases: 2024-11 · check-in free text available
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2022-04-14
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-04-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-07-15
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2022-07-18
Dose 4 — Moderna
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2022-07-19
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
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2022-07-20
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fever · Headache, Joint pains, Fatigue or tirednessAdult check-in
-
2022-07-21
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness, DiarrheaAdult check-in
- 2022-07-22
- 2022-07-23
- 2022-07-24
- 2022-07-25
- 2022-08-01
- 2022-08-08
- 2022-08-15
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2022-08-22
Survey response — day 35, dose 4MedDRA: Body temperature increased, Cough, Diarrhoea, Headache, Oropharyngeal pain, Pain, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: 99-100+ fever, body aches, headache, diarrhea, congestion, cough, sore throat. Both my husband and I tested positive for COVID 1st time @ home 8/18 nite and validated CVS PCR 8/19-20.MedDRA releases: 2024-11 · check-in free text available
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2022-08-29
Survey response — day 42, dose 4MedDRA: Body temperature increased, Cough, Diarrhoea, Fatigue, Headache, Pain, SARS-CoV-2 test negative, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I have been COVID positive 8/18 thru neg test 8/28. Fever100+, extreme fatigue, Headache and all over body aches, Diarrhea and coughingMedDRA releases: 2024-11 · check-in free text available
- 2022-10-17
- 2023-01-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-30 | Moderna | |
| 2 | 2021-04-27 | Moderna | |
| 3 | 2022-01-11 | Moderna | No |
| 4 | 2022-07-18 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-08 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-02-17 | Successful 2022-02-21 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-04-14 | Successful 2022-04-19 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 8 — day 0, dose 2
Systemic reaction (other): vision is extremely skewed. I have Fuchs Dystrophy and a 32 QED monitor for work that I struggled to see. The corneal degeneration symptom did no occur with the 1st Vaccine.
Release 8 — day 7, dose 2
Systemic reaction (other): No
Release 11 — day 28, dose 3
Symptoms: Flu symptoms-fever, body aches headache, chills Fu B+ on Fri., 2/4 rapid test. Then negative COVID, Flu A & B PCR results. I've had positive Flu B tests 5/1/20 and 3/17/21, even though I have flu shot yearly.
Healthcare visit (other): Primary Care Office Nurse Practitioner Visir
Release 11 — day 35, dose 3
Symptoms: Continue low grade fever since 1/31 - dx Flu B (2/3) and then Flu A (2/11) - both rapid. The fatigue and eyes burning are ridiculous. However 2 Negative COVID PCRs (2/3 @ CVS - and 2/4 @ Dr office).
Healthcare visit (other): PCP Office Visits
Release 11 — 3 months, dose 3
Symptoms: Acute sinusitis, Acute bronchitis and Laryngitis (Dr 3/25) and Rx
Release 12 — day 35, dose 4
Symptoms: 99-100+ fever, body aches, headache, diarrhea, congestion, cough, sore throat. Both my husband and I tested positive for COVID 1st time @ home 8/18 nite and validated CVS PCR 8/19-20.
Release 12 — day 42, dose 4
Symptoms: I have been COVID positive 8/18 thru neg test 8/28. Fever100+, extreme fatigue, Headache and all over body aches, Diarrhea and coughing
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 | · | · | ✓ |
| SD | Acute sinusitis | · | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Eye irritation | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Influenza A virus test negative | · | · | ✓ |
| SD | Influenza A virus test positive | · | · | ✓ |
| SD | Influenza B virus test positive | · | · | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Laryngitis | · | · | ✓ |
| SD | Medical counselling | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Visual impairment | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release