Y9S-13163-07126
5 vaccinations
6 coded responses
40 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 303 / GA
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Dose 1 — Moderna
-
2021-01-16
Registered in v-safe
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-22
- 2021-01-29
- 2021-02-05
-
2021-02-12
Dose 2 — Moderna
-
2021-02-12
Survey response — day 0, dose 2MedDRA: Immunisation — Feeling: GoodFree text: I just received the vaccine just about 2 hours ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Medical counselling — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: I called my brother-in-law who is a physician.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Report sent to call center — days 1–6 daily, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-02-15
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Not sure if this mild rash is related. The rash is a few inches below where I received the injection. The rash is very mild.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-16
Survey response — days 1–6 daily, dose 2MedDRA: Injection site rash — Feeling: Good · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Rash is less today than yesterday. Very mild. It is on arm below where injection was given. Do not know if it is actually related to the injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-18
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-05-14
- 2021-08-01
-
2021-08-02
Call successfulParticipant prefers to complete VAERS report online
-
2021-08-15
Survey response — 6 months, dose 2MedDRA: Vertigo — Feeling: Good · Be unable to do your normal daily activitiesFree text: I have had 3 episodes of Vertigo.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-28
Dose 3 — Moderna
- 2022-02-12
-
2022-04-19
Dose 4 — Moderna
- 2022-04-28
-
2022-05-03
Survey response — day 14, dose 4MedDRA: Dizziness, Vertigo — Feeling: Good · Be unable to do your normal daily activitiesFree text: On a couple of days after receiving each of my Moderna vaccines & boosters I experienced vertigo and lightheadedness.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-07-19
-
2022-10-07
Dose 5 — Moderna
- 2022-10-19
- 2022-10-19
- 2022-10-21
- 2022-10-28
- 2022-11-06
- 2022-11-11
- 2022-11-18
- 2023-01-06
- 2023-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-04-19 | Moderna | No |
| 5 | 2022-10-07 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-13 | Successful 2021-08-02 |
Participant prefers to complete VAERS report online |
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): I just received the vaccine just about 2 hours ago.
Release 4 — days 1–6 daily, dose 2
Healthcare visit (other): I called my brother-in-law who is a physician.
Systemic reaction (other): Not sure if this mild rash is related. The rash is a few inches below where I received the injection. The rash is very mild.
Systemic reaction (other): Rash is less today than yesterday. Very mild. It is on arm below where injection was given. Do not know if it is actually related to the injection.
Release 9 — 6 months, dose 2
Symptoms: I have had 3 episodes of Vertigo.
Release 11 — day 14, dose 4
Symptoms: On a couple of days after receiving each of my Moderna vaccines & boosters I experienced vertigo and lightheadedness.
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 |
|---|---|---|---|---|
| HCVO | Medical counselling | ✓ | ✓ | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Vertigo | ✓ | · | ✓ |
| SRO | Immunisation | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release