YC5-29568-13383
5 vaccinations
13 coded responses
56 check-ins
13 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 907 / CA
- Registered
- 2021-02-17
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-17
Registered in v-safe
-
2021-02-17
Dose 1 — Moderna
- 2021-02-17
-
2021-02-18
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Joint painsFree text: Its mildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-03-03
- 2021-03-10
-
2021-03-15
Dose 2 — Moderna
-
2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activitiesFree text: All this happened on March 16MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
- 2021-03-19
- 2021-03-20
-
2021-03-21
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: Pain · HeadacheFree text: Eye and headMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-04-12
-
2021-04-19
Survey response — day 35, dose 2MedDRA: Headache, Migraine — Feeling: PoorFree text: Headaches for more than a month. Hard to sleep. I do have history of migraines, but this is excessive.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-26
- 2021-06-14
-
2021-09-13
Survey response — 6 months, dose 2MedDRA: Vitreous floaters — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Left eye floatersMedDRA releases: 2024-11 · check-in free text available
-
2021-09-13
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-16
- 2021-09-21
-
2021-09-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-10-26
Dose 3 — Moderna
-
2021-10-26
Survey response — day 0, dose 3MedDRA: Unevaluable event — Feeling: FairFree text: I just took the shot 15 minutes ago. Too soon.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Adverse reaction — Feeling: Fair · HeadacheFree text: ModerateMedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
- 2021-10-29
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Headache — Feeling: GoodFree text: Mild headacheMedDRA releases: 2024-11 · check-in free text available
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-09
- 2021-11-16
- 2021-11-25
- 2021-11-30
- 2021-12-07
- 2022-01-25
-
2022-04-26
Survey response — 6 months, dose 3MedDRA: Foreign body in throat — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I have a false tooth stuck in my throat and (b)(6) can't find it with an X-ray and refuses to use an endoscopyMedDRA releases: 2024-11 · check-in free text available
-
2022-04-26
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-29
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-11
Dose 4 — Moderna
-
2022-05-14
Survey response — days 1–6 daily, dose 4MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains · Be unable to do your normal daily activitiesFree text: These were experienced for two days following the shot. But today I'm better.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-15
- 2022-05-16
- 2022-05-17
-
2022-05-18
Survey response — day 7, dose 4MedDRA: Headache — Feeling: Good · HeadacheFree text: Just headacheMedDRA releases: 2024-11 · check-in free text available
- 2022-05-25
- 2022-06-01
- 2022-06-08
- 2022-06-15
- 2022-06-22
-
2022-08-10
Survey response — 3 months, dose 4MedDRA: Breast cancer — Feeling: GoodFree text: Cancer right breastMedDRA releases: 2024-11 · check-in free text available
-
2022-10-13
Dose 5 — Moderna
-
2022-10-27
Survey response — day 14, dose 5MedDRA: Breast abscess, Breast cancer, Post procedural complication — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Breast cancer, nd abscess at surgical siteMedDRA releases: 2024-11 · check-in free text available
-
2022-10-27
Report sent to call center — day 14, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-10-28
- 2022-11-03
- 2022-11-10
- 2022-11-17
- 2022-11-24
- 2023-01-12
- 2023-04-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-17 | Moderna | |
| 2 | 2021-03-15 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-05-11 | Moderna | No |
| 5 | 2022-10-13 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-09-13 | Successful 2021-09-23 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-04-26 | Successful 2022-04-29 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-10-27 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Its mild
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): All this happened on March 16
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Eye and head
Release 7 — day 35, dose 2
Symptoms: Headaches for more than a month. Hard to sleep. I do have history of migraines, but this is excessive.
Release 9 — 6 months, dose 2
Symptoms: Left eye floaters
Release 10 — day 0, dose 3
Systemic reaction (other): I just took the shot 15 minutes ago. Too soon.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Moderate
Systemic reaction (other): Mild headache
Release 11 — 6 months, dose 3
Symptoms: I have a false tooth stuck in my throat and (b)(6) can't find it with an X-ray and refuses to use an endoscopy
redacted (b)(6)
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): These were experienced for two days following the shot. But today I'm better.
Release 11 — day 7, dose 4
Systemic reaction (other): Just headache
Release 12 — 3 months, dose 4
Symptoms: Cancer right breast
Release 12 — day 14, dose 5
Symptoms: Breast cancer, nd abscess at surgical site
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 | Breast abscess | · | · | ✓ |
| SD | Breast cancer | · | · | ✓ |
| SD | Foreign body in throat | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Migraine | ✓ | ✓ | ✓ |
| SD | Post procedural complication | · | · | ✓ |
| SD | Vitreous floaters | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release