Y9E-25731-54282
5 vaccinations
11 coded responses
47 check-ins
11 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 981 / WA
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Registered in v-safe
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2021-01-25
Dose 1 — Moderna
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2021-01-25
Survey response — day 0, dose 1MedDRA: Injection site pain — Feeling: Good · Muscle or body achesFree text: I only experienced the slightest soreness at the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Musculoskeletal stiffness, Rash — Feeling: Good · Site: Pain · Muscle or body aches, Rash, not including the immediate area around the injection siteFree text: At the site of the injection more stiffness and soreness than yesterday. a very small patch of rash on opposite upper arm (2 inches by .5 inch)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-27
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Musculoskeletal stiffness — Feeling: Good · Site: Pain · Muscle or body achesFree text: much less soreness and stiffness at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-08
- 2021-02-15
- 2021-02-22
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2021-02-28
Dose 2 — Moderna
- 2021-02-28
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2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-14
- 2021-03-21
- 2021-03-28
- 2021-04-04
- 2021-04-11
- 2021-05-30
- 2021-08-29
-
2021-11-20
Dose 3 — Moderna
-
2021-11-20
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-11-21
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Sore throat and nasal congestionMedDRA releases: 2024-11 · check-in free text available
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2021-11-22
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Sore throat, runny noseMedDRA releases: 2024-11 · check-in free text available
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2021-11-23
Survey response — days 1–6 daily, dose 3MedDRA: Rhinorrhoea — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
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2021-11-24
Survey response — days 1–6 daily, dose 3MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: runny nose, chest congestionMedDRA releases: 2024-11 · check-in free text available
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2021-11-26
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion — Feeling: Poor · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Nasal congestionMedDRA releases: 2024-11 · check-in free text available
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2021-11-27
Survey response — day 7, dose 3MedDRA: Nasal congestion — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activitiesFree text: nasal congestionMedDRA releases: 2024-11 · check-in free text available
- 2021-12-04
- 2021-12-11
- 2021-12-18
- 2021-12-25
- 2022-01-01
- 2022-02-19
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2022-04-30
Dose 4 — Moderna
- 2022-05-15
- 2022-05-21
- 2022-05-28
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2022-06-04
Survey response — day 35, dose 4MedDRA: Headache, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: Sore throat and headacheMedDRA releases: 2024-11 · check-in free text available
- 2022-06-11
- 2022-07-30
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2022-10-29
Survey response — 6 months, dose 4MedDRA: Nasopharyngitis, Wrist fracture — 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: I have a cold and I fractured my wristMedDRA releases: 2024-11 · check-in free text available
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2022-10-29
Report sent to call center — 6 months, dose 4Be 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)
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2022-11-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-11-17
Dose 5 — Moderna
- 2023-05-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | |
| 2 | 2021-02-28 | Moderna | |
| 3 | 2021-11-20 | Moderna | No |
| 4 | 2022-04-30 | Moderna | No |
| 5 | 2022-11-17 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-29 | Successful 2022-11-01 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): I only experienced the slightest soreness at the injection site
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): At the site of the injection more stiffness and soreness than yesterday. a very small patch of rash on opposite upper arm (2 inches by .5 inch)
Systemic reaction (other): much less soreness and stiffness at injection site
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sore throat and nasal congestion
Systemic reaction (other): Sore throat, runny nose
Systemic reaction (other): Runny nose
Systemic reaction (other): runny nose, chest congestion
Systemic reaction (other): Nasal congestion
Release 10 — day 7, dose 3
Systemic reaction (other): nasal congestion
Release 11 — day 35, dose 4
Symptoms: Sore throat and headache
Release 12 — 6 months, dose 4
Symptoms: I have a cold and I fractured my wrist
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 | Headache | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Wrist fracture | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release