Y9H-17594-18726
3 vaccinations
8 coded responses
14 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 919 / CA
- Registered
- 2021-02-15
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-02
Dose 1 — Moderna
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2021-02-15
Registered in v-safe
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2021-02-16
Survey response — day 14, dose 1MedDRA: Back pain, Chest pain, Nasopharyngitis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Day 2: experienced cold-like symptoms.Back and chest pain on same side as vaccination shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Dose 2 — Moderna
- 2021-03-16
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2021-03-26
Survey response — day 21, dose 2MedDRA: Headache, Oropharyngeal pain, Pain — Feeling: FairFree text: Headache, body ache, sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-11-21
Dose 3 — Moderna
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2021-11-22
Survey response — days 1–6 daily, dose 3MedDRA: Ear discomfort, Paraesthesia — Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: tingling sensation from the top of my head to the base of my neck on the right side; and tingling on the right side of my face. My right ear also felt like it was clogged. Some slight tingling in my arms and in the bottom of my foot. The symptoms arMedDRA releases: 2024-11 · check-in free text available
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2021-11-22
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-11-23
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body achesAdult check-in
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2021-11-23
Call successfulParticipant prefers to complete VAERS report online
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2021-11-24
Survey response — days 1–6 daily, dose 3MedDRA: Paraesthesia — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: tingling on right side of head/face/forearmMedDRA releases: 2024-11 · check-in free text available
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2021-11-25
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain, Paraesthesia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body achesFree text: slight tingling on right side of face/head, sore throatMedDRA releases: 2024-11 · check-in free text available
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2021-11-27
Survey response — days 1–6 daily, dose 3MedDRA: Paraesthesia — Feeling: Fair · Headache, Joint pains, Muscle or body achesFree text: tingling in head and faceMedDRA releases: 2024-11 · check-in free text available
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2021-11-28
Health check-in — day 7, dose 3Feeling: Fair · Joint pains, Muscle or body achesFree text: mild tingling in head and face right sideAdult check-in · check-in free text available
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2021-12-09
Survey response — day 14, dose 3MedDRA: Arthralgia, Myalgia, Paraesthesia — Feeling: FairFree text: muscle aches and joint pain. tingling on right side of face/headMedDRA releases: 2024-11 · check-in free text available
- 2021-12-14
- 2021-12-29
- 2022-01-04
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2022-02-21
Survey response — 3 months, dose 3MedDRA: Pain, Swelling — Feeling: FairFree text: pain swelling on right sideMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-02 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-11-21 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-22 | Successful 2021-11-23 |
Participant prefers to complete VAERS report online |
Free text
Release 4 — day 14, dose 1
Symptoms: Day 2: experienced cold-like symptoms.Back and chest pain on same side as vaccination shot
Release 6 — day 21, dose 2
Symptoms: Headache, body ache, sore throat
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): tingling sensation from the top of my head to the base of my neck on the right side; and tingling on the right side of my face. My right ear also felt like it was clogged. Some slight tingling in my arms and in the bottom of my foot. The symptoms ar cut off by CDC
Systemic reaction (other): tingling on right side of head/face/forearm
Systemic reaction (other): slight tingling on right side of face/head, sore throat
Systemic reaction (other): tingling in head and face
Release 10 — day 14, dose 3
Symptoms: muscle aches and joint pain. tingling on right side of face/head
Release 11 — 3 months, dose 3
Symptoms: pain swelling on right side
Release 12 — day 7, dose 3
Systemic reaction (other): mild tingling in head and face right side
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 | Arthralgia | · | · | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SD | Swelling | · | · | ✓ |
| SRO | Ear discomfort | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Paraesthesia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release