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YGS-27069-16835

4 vaccinations 13 coded responses 52 check-ins 12 free-text entries 8 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
622 / IL
Registered
2021-01-12
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-12
    Registered in v-safe
  2. 2021-01-12
    Dose 1 — Moderna
  3. 2021-01-12
    Health check-in — day 0, dose 1
    Feeling: Good · Chills
    Adult check-in
  4. 2021-01-13
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chest pain — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Chest pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-13
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to do your normal daily activities
    1 call case(s)
  6. 2021-01-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-01-14
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to do your normal daily activities
    1 call case(s)
  8. 2021-01-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  9. 2021-01-15
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to do your normal daily activities
    1 call case(s)
  10. 2021-01-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  12. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  13. 2021-01-19
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  14. 2021-01-26
    Survey response — day 14, dose 1
    MedDRA: Unevaluable event — Feeling: Good
    Free text: Forgot to previously report lump in side of neck (same side as vaccine) that appeared 1-2 days after vaccine. Assumed it was a swollen lymph node. It's still there. Unsure if it's related or coincidental. Will contact doctor if still there in a week.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-02
    Survey response — day 21, dose 1
    MedDRA: Dyspnoea, Night sweats — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Frequent night sweats and shortness of breath upon minimal exertion.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-02
    Report sent to call center — day 21, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-02-09
    Dose 2 — Moderna
  18. 2021-02-09
    Survey response — day 0, dose 2
    MedDRA: Dizziness — Feeling: Fair · Chills, Headache
    Free text: Dizziness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-02-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  20. 2021-02-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cough — Feeling: Fair · Site: Pain · Headache, Joint pains
    Free text: Dry cough
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-02-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cough — Feeling: Fair · Site: Pain · Headache, Joint pains
    Free text: Dry cough
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache · Be unable to do your normal daily activities
    Adult check-in
  23. 2021-02-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  24. 2021-02-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  25. 2021-02-16
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  26. 2021-02-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-03-02
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-03-09
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-03-16
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  30. 2021-03-23
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  31. 2021-05-11
    Survey response — 3 months, dose 2
    MedDRA: Bradycardia, Fatigue, Pre-existing disease, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: Bradycardia (when I normally have tachycardia, so this is a very pronounced difference for me), increased fatigue · Healthcare visit (other): Outpatient testing
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  32. 2021-05-11
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  33. 2021-06-10
  34. 2021-08-10
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  35. 2021-11-05
    Dose 3 — Moderna
  36. 2021-11-07
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea
    Adult check-in
  37. 2021-11-08
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness
    Adult check-in
  38. 2021-11-09
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Fever · Headache, Fatigue or tiredness
    Adult check-in
  39. 2021-11-11
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Headache · Be unable to do your normal daily activities
    Adult check-in
  40. 2021-11-12
    Health check-in — day 7, dose 3
    Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  41. 2021-11-19
    Health check-in — day 14, dose 3
    Feeling: Fair
    Adult check-in
  42. 2021-11-26
    Health check-in — day 21, dose 3
    Feeling: Fair
    Adult check-in
  43. 2021-12-03
    Survey response — day 28, dose 3
    MedDRA: Cough, Fatigue, Headache, Insomnia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Cough, fatigue, sleeplessness, headache
    MedDRA releases: 2024-11 · check-in free text available
  44. 2021-12-10
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  45. 2021-12-17
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  46. 2022-02-04
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  47. 2022-05-06
    Health check-in — 6 months, dose 3
    Feeling: Fair
    Adult check-in
  48. 2022-11-17
    Dose 4 — Moderna
  49. 2022-11-17
    Health check-in — day 0, dose 4
    Feeling: Good · Headache · Be unable to do your normal daily activities
    Adult check-in
  50. 2022-11-18
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  51. 2022-11-19
    Survey response — days 1–6 daily, dose 4
    MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activities
    Free text: Runny nose
    MedDRA releases: 2024-11 · check-in free text available
  52. 2022-11-20
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  53. 2022-11-21
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Headache
    Adult check-in
  54. 2022-11-22
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  55. 2022-11-23
    Survey response — days 1–6 daily, dose 4
    MedDRA: Tenderness — Feeling: Fair
    Free text: Significant bilateral neck tenderness straight down from ear, greater on same side as injection (also had yesterday but forgot to report)
    MedDRA releases: 2024-11 · check-in free text available
  56. 2022-11-24
    Health check-in — day 7, dose 4
    Feeling: Fair · Headache · Be unable to do your normal daily activities
    Adult check-in
  57. 2022-12-01
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  58. 2022-12-08
    Health check-in — day 21, dose 4
    Feeling: Fair
    Adult check-in
  59. 2022-12-15
    Survey response — day 28, dose 4
    MedDRA: Alopecia, Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Extreme hair loss and increased headaches
    MedDRA releases: 2024-11 · check-in free text available
  60. 2022-12-15
    Report sent to call center — day 28, dose 4
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  61. 2022-12-16
  62. 2022-12-16
  63. 2022-12-16
  64. 2022-12-22
    Health check-in — day 35, dose 4
    Feeling: Fair
    Adult check-in
  65. 2022-12-29
    Survey response — day 42, dose 4
    MedDRA: Alopecia, Fatigue, Pruritus, Weight decreased — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Significant weight loss, hair loss, fatigue, itching
    MedDRA releases: 2024-11 · check-in free text available
  66. 2022-12-29
    Report sent to call center — day 42, dose 4
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  67. 2022-12-30
  68. 2022-12-30
  69. 2022-12-30
  70. 2022-12-30
  71. 2023-02-16
    Survey response — 3 months, dose 4
    MedDRA: Alopecia, Fatigue, Mass, Unevaluable event, Weight decreased — 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 · Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  72. 2023-02-16
    Report sent to call center — 3 months, dose 4
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  73. 2023-02-17
  74. 2023-02-17
  75. 2023-02-17
  76. 2023-05-20
    Health check-in — 6 months, dose 4
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-12Moderna
22021-02-09Moderna
32021-11-05Moderna No
42022-11-17Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-01-13 priority 2/3
2021-01-14 priority 2/3
2021-01-15 priority 2/3
2021-02-02 Unsuccessful
2021-05-11 Unsuccessful
2022-12-15 Unsuccessful
2022-12-29 Unsuccessful
2023-02-16 Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-13

Systemic reaction (other): Chest pain

Release 2 — day 14, dose 1

2021-01-26

Symptoms: Forgot to previously report lump in side of neck (same side as vaccine) that appeared 1-2 days after vaccine. Assumed it was a swollen lymph node. It's still there. Unsure if it's related or coincidental. Will contact doctor if still there in a week. cut off by CDC

Release 3 — day 21, dose 1

2021-02-02

Symptoms: Frequent night sweats and shortness of breath upon minimal exertion.

Release 3 — day 0, dose 2

2021-02-09

Systemic reaction (other): Dizziness

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Dry cough

2021-02-12

Systemic reaction (other): Dry cough

Release 8 — 3 months, dose 2

2021-05-11

Symptoms: Bradycardia (when I normally have tachycardia, so this is a very pronounced difference for me), increased fatigue
Healthcare visit (other): Outpatient testing

Release 10 — day 28, dose 3

2021-12-03

Symptoms: Cough, fatigue, sleeplessness, headache

Release 12 — days 1–6 daily, dose 4

2022-11-19

Systemic reaction (other): Runny nose

2022-11-23

Systemic reaction (other): Significant bilateral neck tenderness straight down from ear, greater on same side as injection (also had yesterday but forgot to report)

Release 12 — day 28, dose 4

2022-12-15

Symptoms: Extreme hair loss and increased headaches

Release 12 — day 42, dose 4

2022-12-29

Symptoms: Significant weight loss, hair loss, fatigue, itching

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event ✓ ✓ ✓
SDAlopecia · · ✓
SDBradycardia ✓ · ✓
SDCough · · ✓
SDDyspnoea ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeadache · · ✓
SDInsomnia · · ✓
SDMass · · ✓
SDNight sweats ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDPruritus · · ✓
SDUnevaluable event ✓ ✓ ✓
SDWeight decreased · · ✓
SROChest pain ✓ ✓ ✓
SROCough ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SRORhinorrhoea · · ✓
SROTenderness · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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