YH2-11041-63165
5 vaccinations
9 coded responses
58 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 109 / NY
- Registered
- 2021-02-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-16
Registered in v-safe
-
2021-02-16
Dose 1 — Moderna
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
-
2021-03-02
Survey response — day 14, dose 1MedDRA: Rash — Feeling: GoodFree text: On Sunday 2/28 appeared what looks like a Lyme disease birdeye rash. About 4-5 in diameter. No pain, no heat, no other symptoms of any kind. It has faded but still barely noticeable now 3/2.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
-
2021-03-16
Dose 2 — Moderna
- 2021-03-16
-
2021-03-17
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-03-18
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to workAdult check-in
-
2021-03-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-06-15
- 2021-09-14
-
2021-10-28
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend schoolAdult check-in
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-04
- 2021-12-09
- 2022-01-27
-
2022-04-06
Dose 4 — Moderna
-
2022-04-06
Survey response — day 0, dose 4MedDRA: Dry mouth — Feeling: Good · Site: Pain, SwellingFree text: Dry mouthMedDRA releases: 2024-11 · check-in free text available
-
2022-04-07
Survey response — days 1–6 daily, dose 4MedDRA: Muscle spasms — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal painFree text: Charlie horse (calf muscle spasm)MedDRA releases: 2024-11 · check-in free text available
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2022-04-08
Survey response — days 1–6 daily, dose 4MedDRA: Muscle spasms, Peripheral swelling — Feeling: Good · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body achesFree text: Calves are cramping like a charlie horse but not as serve. Swelling in fingers, like a large Chinese food meal was eaten (subsided by midday)MedDRA releases: 2024-11 · check-in free text available
-
2022-04-09
Survey response — days 1–6 daily, dose 4MedDRA: Muscle spasms, Myalgia — Feeling: Good · Muscle or body achesFree text: Same as previous days - calf muscle Charlie horse like soreness. Comes and goes, but much improved from yesterday and the day before. No redness or tenderness at the site. Started drinking Gatorade and improvement followed. Thinking I'm dehydrateMedDRA releases: 2024-11 · check-in free text available
-
2022-04-10
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling, Itching · Muscle or body achesAdult check-in
- 2022-04-11
- 2022-04-12
-
2022-04-13
Survey response — day 7, dose 4MedDRA: Muscle spasms — Feeling: GoodFree text: Calf muscle spasm returned - mild.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-20
- 2022-04-29
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-07-08
-
2022-09-08
Dose 5 — Moderna
-
2022-10-07
Survey response — 6 months, dose 4MedDRA: Sinusitis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sinus infectionMedDRA releases: 2024-11 · check-in free text available
- 2022-10-12
- 2022-10-15
- 2022-10-20
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2022-12-08
Survey response — 3 months, dose 5MedDRA: COVID-19 — 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 · Telehealth, virtual health, or email health consultationFree text: Covid and rebound covid 1st case 11/22 - rec'v Paxlovid (completed, on time) 2nd case 12/3MedDRA releases: 2024-11 · check-in free text available
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2022-12-08
Report sent to call center — 3 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-12-09
-
2022-12-16
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2023-03-10
Survey response — 6 months, dose 5MedDRA: Fungal infection, Gastroenteritis viral, Urinary tract infection — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-03-10
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-03-13
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-16 | Moderna | |
| 2 | 2021-03-16 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-04-06 | Moderna | No |
| 5 | 2022-09-08 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-08 | Successful 2022-12-16 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-03-10 | Successful 2023-03-13 |
Participant prefers to complete VAERS report online |
Free text
Release 4 — day 14, dose 1
Symptoms: On Sunday 2/28 appeared what looks like a Lyme disease birdeye rash. About 4-5 in diameter. No pain, no heat, no other symptoms of any kind. It has faded but still barely noticeable now 3/2.
Release 11 — day 0, dose 4
Systemic reaction (other): Dry mouth
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Charlie horse (calf muscle spasm)
Systemic reaction (other): Calves are cramping like a charlie horse but not as serve. Swelling in fingers, like a large Chinese food meal was eaten (subsided by midday)
Systemic reaction (other): Same as previous days - calf muscle Charlie horse like soreness. Comes and goes, but much improved from yesterday and the day before. No redness or tenderness at the site. Started drinking Gatorade and improvement followed. Thinking I'm dehydrate cut off by CDC
Release 11 — day 7, dose 4
Systemic reaction (other): Calf muscle spasm returned - mild.
Release 12 — 6 months, dose 4
Symptoms: Sinus infection
Release 12 — 3 months, dose 5
Symptoms: Covid and rebound covid 1st case 11/22 - rec'v Paxlovid (completed, on time) 2nd case 12/3
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 | COVID-19 | · | · | ✓ |
| SD | Fungal infection | · | · | ✓ |
| SD | Gastroenteritis viral | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Dry mouth | · | · | ✓ |
| SRO | Muscle spasms | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Peripheral swelling | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release