YBU-17417-28059
2 vaccinations
4 coded responses
17 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 977 / OR
- Registered
- 2021-02-12
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-12
Registered in v-safe
-
2021-02-12
Dose 1 — Moderna
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-19
- 2021-02-26
- 2021-03-05
-
2021-03-12
Dose 2 — Moderna
-
2021-03-19
Survey response — day 7, dose 2MedDRA: Ageusia, Fatigue, Headache — Feeling: Fair · 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 activitiesFree text: Loss of taste the first 3 days of 2nd vaccine, severe fatigue, headaches for the first 3 daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
- 2021-04-02
- 2021-04-09
-
2021-04-16
Survey response — day 35, dose 2MedDRA: Abdominal distension, Diarrhoea, Dizziness, Headache — Feeling: Fair · Be unable to workFree text: Diarrhea, sharp quick head ache, dizziness, bloatingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
-
2021-06-11
Survey response — 3 months, dose 2MedDRA: Fatigue, Feeling hot, Headache, Pyrexia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Randomly feeling HOT, feverish , headache, then fine. At other times feeling very tired during the day . Which is NOT normal for me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-09-12
Survey response — 6 months, dose 2MedDRA: Asthenia, Headache, Heart rate decreased, Hypotension, Pain, Shoulder injury related to vaccine administration — 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: Low pulse rate , 34, 36, 43. And low blood pressure. Headaches. Weakness. Also have SIRVA, she gave me the shot too high in my shoulder - im in pain daily since march 12th 2021. I hoped it would go away , but it has notMedDRA releases: 2024-11 · check-in free text available
-
2021-09-12
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-12 | Moderna | |
| 2 | 2021-03-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-09-12 | Unsuccessful |
Free text
Release 6 — day 7, dose 2
Systemic reaction (other): Loss of taste the first 3 days of 2nd vaccine, severe fatigue, headaches for the first 3 days
Release 7 — day 35, dose 2
Symptoms: Diarrhea, sharp quick head ache, dizziness, bloating
Release 9 — 3 months, dose 2
Symptoms: Randomly feeling HOT, feverish , headache, then fine. At other times feeling very tired during the day . Which is NOT normal for me.
Release 9 — 6 months, dose 2
Symptoms: Low pulse rate , 34, 36, 43. And low blood pressure. Headaches. Weakness. Also have SIRVA, she gave me the shot too high in my shoulder - im in pain daily since march 12th 2021. I hoped it would go away , but it has not
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 | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling hot | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Heart rate decreased | · | · | ✓ |
| SD | Hypotension | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Shoulder injury related to vaccine administration | · | · | ✓ |
| SRO | Ageusia | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release