Y9Q-20437-69416
2 vaccinations
4 coded responses
24 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 029 / RI
- Registered
- 2021-02-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-20
Registered in v-safe
-
2021-02-20
Dose 1 — Moderna
- 2021-02-20
- 2021-02-21
-
2021-02-22
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Nausea · Be unable to workFree text: Arm is sore but not too badMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
-
2021-03-06
Survey response — day 14, dose 1MedDRA: Headache, Injection site erythema, Injection site pruritus — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: HeadachesRedness and itchiness at the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
-
2021-03-20
Dose 2 — Moderna
-
2021-03-21
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-22
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-03-23
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-29
- 2021-04-03
- 2021-04-11
- 2021-04-17
- 2021-04-24
- 2021-05-03
- 2021-06-21
-
2021-09-20
Survey response — 6 months, dose 2MedDRA: Dizziness, Dyspnoea — Feeling: FairFree text: Trouble breathing. Dizzy.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-20
Survey response — 12 months, dose 2MedDRA: COVID-19, Sinusitis — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Covid and sinus infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-03-20
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-03-23
-
2022-03-28
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-20 | Moderna | |
| 2 | 2021-03-20 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-20 | Successful 2022-03-28 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Arm is sore but not too bad
Release 5 — day 14, dose 1
Symptoms: HeadachesRedness and itchiness at the injection site
Release 9 — 6 months, dose 2
Symptoms: Trouble breathing. Dizzy.
Release 11 — 12 months, dose 2
Symptoms: Covid and sinus infection
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 | COVID-19 | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release