YAC-16768-62887
4 vaccinations
5 coded responses
37 check-ins
5 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 614 / IL
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Registered in v-safe
-
2021-03-11
Dose 1 — Moderna
- 2021-03-11
-
2021-03-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tirednessAdult check-in
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
- 2021-04-01
-
2021-04-09
Dose 2 — Moderna
- 2021-04-09
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-21
-
2021-07-09
Survey response — 3 months, dose 2MedDRA: Ear discomfort, Pain in jaw, Toothache, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Pain in lower jaw/teeth. Am told it may be TMJ. Also some problems with a feeling of fluid in the ears. Am told by primary care doctor that it could be allergies. Has come about very recently. · Healthcare visit (other): Have upcoming appointment with both a dentist and an ear/nose/ throat doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-09
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-20
-
2021-10-08
Survey response — 6 months, dose 2MedDRA: Fatigue — Feeling: FairFree text: Onset of tiredness when I start to excercise or do chores around the house and yardMedDRA releases: 2024-11 · check-in free text available
-
2021-11-09
Dose 3 — Moderna
-
2022-04-13
Survey response — 12 months, dose 2MedDRA: Herpes zoster — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: ShinglesMedDRA releases: 2024-11 · check-in free text available
-
2022-04-13
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-21
-
2022-04-26
Dose 4 — Moderna
- 2022-04-30
- 2022-05-01
- 2022-05-02
- 2022-05-03
- 2022-05-10
- 2022-05-17
-
2022-05-24
Survey response — day 28, dose 4MedDRA: Cough, Fatigue, Oropharyngeal pain, Rhinorrhoea, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sore throat and sinuses, cough from nasal drainage, tirednessMedDRA releases: 2024-11 · check-in free text available
- 2022-05-31
- 2022-06-07
- 2022-07-26
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2022-10-25
Survey response — 6 months, dose 4MedDRA: Immunisation reaction, Malaise, Office visit, Reaction to previous exposure to any vaccine — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sick with in September, docs don't think it was Covid. Just got better and was able to get Covid booster on October 18. Had reaction to vaccine (always do but worth it) but feeling better now.MedDRA releases: 2024-11 · check-in free text available
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2022-10-25
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-10-26
- 2022-10-26
- 2022-10-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-09 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
| 4 | 2022-04-26 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-09 | Unsuccessful | |
| 2022-04-13 | Unsuccessful | |
| 2022-10-25 | Unsuccessful |
Free text
Release 9 — 3 months, dose 2
Symptoms: Pain in lower jaw/teeth. Am told it may be TMJ. Also some problems with a feeling of fluid in the ears. Am told by primary care doctor that it could be allergies. Has come about very recently.
Healthcare visit (other): Have upcoming appointment with both a dentist and an ear/nose/ throat doctor
Release 10 — 6 months, dose 2
Symptoms: Onset of tiredness when I start to excercise or do chores around the house and yard
Release 11 — 12 months, dose 2
Symptoms: Shingles
Release 11 — day 28, dose 4
Symptoms: Sore throat and sinuses, cough from nasal drainage, tiredness
Release 12 — 6 months, dose 4
Symptoms: Sick with in September, docs don't think it was Covid. Just got better and was able to get Covid booster on October 18. Had reaction to vaccine (always do but worth it) but feeling better now.
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Ear discomfort | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Herpes zoster | · | · | ✓ |
| SD | Immunisation reaction | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain in jaw | ✓ | ✓ | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Toothache | ✓ | ✓ | ✓ |
| SD | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release