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Y9M-14229-97813

3 vaccinations 8 coded responses 29 check-ins 8 free-text entries 2 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
010 / MA
Registered
2021-03-07
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-07
    Registered in v-safe
  2. 2021-03-08
    Dose 1 — Moderna
  3. 2021-03-08
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain · Muscle or body aches
    Adult check-in
  4. 2021-03-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Muscle or body aches
    Adult check-in
  5. 2021-03-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  6. 2021-03-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-15
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-03-22
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-03-29
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-04-05
    Survey response — day 28, dose 1
    MedDRA: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing — Feeling: Good
    Free text: My seasonal allergies seem to be kicking into high gear (sneezing, runny nose, and congestion). My 1.5 yr old son was diagnosed with Covid-19 but so far I have tested negative.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-06
    Dose 2 — Moderna
  15. 2021-04-06
    Survey response — day 0, dose 2
    MedDRA: Ear discomfort — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches
    Free text: Fullness/pressure in my ears
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Loss of consciousness — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: I passed out at 4am when I got up to go to the restroom. I dont remember it but fell and hit my head hard. Im not sure if my headache today is from the fall or the shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-07
    Report sent to call center — days 1–6 daily, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  18. 2021-04-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-04-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-04-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Nasal congestion, Respiratory tract congestion, Tinnitus — Feeling: Good
    Free text: Congestion/stuffy nose, tinnitus
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-04-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Good · Headache
    Free text: Runny nose and congestion
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-04-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Hypersensitivity, Respiratory tract congestion — Feeling: Fair · Joint pains, Muscle or body aches, Diarrhea
    Free text: Increased allergy symptoms - congestion and pressure
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-04-13
    Survey response — day 7, dose 2
    MedDRA: Ear discomfort, Nasal congestion, SARS-CoV-2 test positive — Feeling: Good · Muscle or body aches · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Ear pressure/nasal congestion. Also, I took a Covid pcr test yesterday and tested posiyive
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-04-13
    Report sent to call center — day 7, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  25. 2021-04-21
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  26. 2021-04-27
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-05-04
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-05-11
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-05-18
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  30. 2021-07-06
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  31. 2021-10-05
    Survey response — 6 months, dose 2
    MedDRA: Headache, Pre-existing disease, Weight increased — Feeling: Fair
    Free text: Weight gain, headaches, allergies
    MedDRA releases: 2024-11 · check-in free text available
  32. 2022-01-20
    Dose 3 — Moderna
  33. 2022-02-21
    Call successful
    Reported to VAERS voluntarily prior to GDIT contact
  34. 2022-04-06
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  35. 2022-07-23
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  36. 2023-01-20
    Health check-in — 12 months, dose 3
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-08Moderna
22021-04-06Moderna
32022-01-20Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-04-07 Successful
2022-02-21
 Reported to VAERS voluntarily prior to GDIT contact
2021-04-13 Successful Reported to VAERS voluntarily prior to GDIT contact

Free text

Release 6 — day 28, dose 1

2021-04-05

Symptoms: My seasonal allergies seem to be kicking into high gear (sneezing, runny nose, and congestion). My 1.5 yr old son was diagnosed with Covid-19 but so far I have tested negative.

Release 7 — day 0, dose 2

2021-04-06

Systemic reaction (other): Fullness/pressure in my ears

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): I passed out at 4am when I got up to go to the restroom. I dont remember it but fell and hit my head hard. Im not sure if my headache today is from the fall or the shot.

2021-04-10

Systemic reaction (other): Congestion/stuffy nose, tinnitus

2021-04-11

Systemic reaction (other): Runny nose and congestion

2021-04-12

Systemic reaction (other): Increased allergy symptoms - congestion and pressure

Release 7 — day 7, dose 2

2021-04-13

Systemic reaction (other): Ear pressure/nasal congestion. Also, I took a Covid pcr test yesterday and tested posiyive

Release 10 — 6 months, dose 2

2021-10-05

Symptoms: Weight gain, headaches, allergies

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

FieldPreferred term2021-092023-042024-11
SDHeadache · · ✓
SDPre-existing disease · · ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓
SDSneezing ✓ ✓ ✓
SDWeight increased · · ✓
SROEar discomfort ✓ ✓ ✓
SROHypersensitivity ✓ ✓ ✓
SROLoss of consciousness ✓ ✓ ✓
SRONasal congestion ✓ ✓ ✓
SRORespiratory tract congestion ✓ ✓ ✓
SRORhinorrhoea ✓ ✓ ✓
SROSARS-CoV-2 test positive ✓ ✓ ✓
SROTinnitus ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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