YH2-16403-09551
2 vaccinations
4 coded responses
15 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 373 / TN
- Registered
- 2020-12-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-27
Registered in v-safe
-
2020-12-27
Dose 1 — Moderna
-
2020-12-28
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Reaction to previous exposure to any vaccine — Feeling: GoodFree text: Sore where I got the shot like with flu shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-10
- 2021-01-17
-
2021-01-24
Dose 2 — Moderna
-
2021-02-07
Survey response — day 14, dose 2MedDRA: Ear disorder, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: Inner ear issue with lt ear. Don't believe it is vaccine related.My hormone lab work was not good! Has been good for last 3 years. The only that had changed was me getting vaccines. Trying to get them straightened out. · Healthcare visit (other): New lab workMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-07
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-14
Survey response — day 21, dose 2MedDRA: Medical counselling, Vertigo — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Inner ear vertigo · Healthcare visit (other): (b)(6) healthcare dr. I misses two days work on an antibiotic and nausea vertigo medicine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-14
Report sent to call center — day 21, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-21
- 2021-02-28
- 2021-03-07
-
2021-04-25
Survey response — 3 months, dose 2MedDRA: Sinusitis — Feeling: Fair · Be unable to work, 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: I have a sinus infection right now I am being treated for and more trouble with my earsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-25
Report sent to call center — 3 months, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-27 | Moderna | |
| 2 | 2021-01-24 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-07 | Unsuccessful | |
| 2021-02-14 | Unsuccessful | |
| 2021-04-25 | Unsuccessful |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Sore where I got the shot like with flu shot
Release 3 — day 14, dose 2
Symptoms: Inner ear issue with lt ear. Don't believe it is vaccine related.My hormone lab work was not good! Has been good for last 3 years. The only that had changed was me getting vaccines. Trying to get them straightened out.
Healthcare visit (other): New lab work
Release 4 — day 21, dose 2
Symptoms: Inner ear vertigo
Healthcare visit (other): (b)(6) healthcare dr. I misses two days work on an antibiotic and nausea vertigo medicine.
redacted (b)(6)
Release 7 — 3 months, dose 2
Symptoms: I have a sinus infection right now I am being treated for and more trouble with my ears
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 | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Ear disorder | ✓ | ✓ | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release