Y9K-33787-42553
4 vaccinations
14 coded responses
53 check-ins
14 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 107 / NY
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Registered in v-safe
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2021-01-06
Dose 1 — Moderna
- 2021-01-06
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2021-01-07
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Sort of light headedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
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2021-01-12
Survey response — days 1–6 daily, dose 1MedDRA: Glossodynia, Oropharyngeal pain — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: Sore throat and tongue which went awayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-13
Survey response — day 7, dose 1MedDRA: Epistaxis, Feeling hot, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, Self-medication, Sneezing — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: In the middle of the night my body ached and my legs hurt. I took Alleve. It helped. I did feel feverish before bed but my temperature was normal. My throat hurt at bedtime. I woke up fine though I sneezed blood in my nose. The rest of today was fine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-27
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2021-02-03
Dose 2 — Moderna
- 2021-02-03
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2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Muscle or body achesAdult check-in
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2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Rash — Feeling: Good · Joint pains, Rash, not including the immediate area around the injection siteFree text: Yesterday I failed to complete the survey and this I couldnt report the rad on my back and belly that lasted Thursday night through last night. Yesterday I also woke up with joint pain in my elbow but today I have none of these symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
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2021-05-06
Survey response — 3 months, dose 2MedDRA: Insomnia, Nerve compression, Spinal stenosis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Spinal stenosis and pinched nerve in my right leg; insomnia.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-06
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-04
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2021-10-25
Dose 3 — Moderna
- 2021-10-25
- 2021-10-26
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2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Chills, Fatigue or tirednessAdult check-in
- 2021-10-28
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2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Oral pain — Feeling: Good · Fatigue or tirednessFree text: Roof of my mouth hurtsMedDRA releases: 2024-11 · check-in free text available
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2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Chills — Feeling: Good · Fatigue or tirednessFree text: Last night chills but not todayMedDRA releases: 2024-11 · check-in free text available
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
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2022-04-18
Call successfulNot applicable - Accidental Reporting
- 2022-04-25
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2022-05-18
Dose 4 — Moderna
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2022-05-19
Survey response — days 1–6 daily, dose 4MedDRA: Oropharyngeal pain — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
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2022-05-20
Survey response — days 1–6 daily, dose 4MedDRA: Oropharyngeal pain — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
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2022-05-20
Report sent to call center — days 1–6 daily, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-05-21
Survey response — days 1–6 daily, dose 4MedDRA: Oropharyngeal pain — Feeling: Fair · Fatigue or tirednessFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
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2022-05-22
Survey response — days 1–6 daily, dose 4MedDRA: Cough, Oropharyngeal pain — Feeling: FairFree text: Cough sore throatMedDRA releases: 2024-11 · check-in free text available
- 2022-05-24
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2022-05-24
Call successfulNot applicable - Accidental Reporting
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2022-05-25
Survey response — day 7, dose 4MedDRA: Respiratory tract infection — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: On antibiotics for respiratory infectionMedDRA releases: 2024-11 · check-in free text available
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2022-05-25
Report sent to call center — day 7, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-05-26
Call successfulNot applicable - Accidental Reporting
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2022-06-01
Survey response — day 14, dose 4MedDRA: Cough, Herpes virus infection, Rash — Feeling: FairFree text: I have continued cough despite antibiotics snd herpes outbreak.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-11
- 2022-06-15
- 2022-06-22
- 2022-06-29
- 2022-08-19
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2022-11-18
Survey response — 6 months, dose 4MedDRA: Oropharyngeal pain, SARS-CoV-2 test positive — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I had booster a week and a half ago and tested positive for covid last Friday . Sore throatMedDRA releases: 2024-11 · check-in free text available
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2022-11-18
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-11-21
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-05-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-05-18 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-06 | Successful 2022-04-18 |
Not applicable - Accidental Reporting |
| 2022-05-20 | Successful 2022-05-24 |
Not applicable - Accidental Reporting |
| 2022-05-25 | Successful 2022-05-26 |
Not applicable - Accidental Reporting |
| 2022-11-18 | Successful 2022-11-21 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Sort of light headed
Systemic reaction (other): Sore throat and tongue which went away
Release 1 — day 7, dose 1
Systemic reaction (other): In the middle of the night my body ached and my legs hurt. I took Alleve. It helped. I did feel feverish before bed but my temperature was normal. My throat hurt at bedtime. I woke up fine though I sneezed blood in my nose. The rest of today was fine.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Yesterday I failed to complete the survey and this I couldnt report the rad on my back and belly that lasted Thursday night through last night. Yesterday I also woke up with joint pain in my elbow but today I have none of these symptoms
Release 8 — 3 months, dose 2
Symptoms: Spinal stenosis and pinched nerve in my right leg; insomnia.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Roof of my mouth hurts
Systemic reaction (other): Last night chills but not today
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Sore throat
Systemic reaction (other): Sore throat
Systemic reaction (other): Sore throat
Systemic reaction (other): Cough sore throat
Release 11 — day 7, dose 4
Systemic reaction (other): On antibiotics for respiratory infection
Release 11 — day 14, dose 4
Symptoms: I have continued cough despite antibiotics snd herpes outbreak.
Release 12 — 6 months, dose 4
Symptoms: I had booster a week and a half ago and tested positive for covid last Friday . Sore throat
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 | Cough | · | · | ✓ |
| SD | Herpes virus infection | · | · | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Nerve compression | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Spinal stenosis | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Epistaxis | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | · | ✓ |
| SRO | Glossodynia | ✓ | ✓ | ✓ |
| SRO | Oral pain | · | · | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ○ | ✓ | ○ |
| SRO | Rash | · | · | ✓ |
| SRO | Respiratory tract infection | · | · | ✓ |
| SRO | Self-medication | ✓ | · | ✓ |
| SRO | Sneezing | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release