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YJE-20501-51808

3 vaccinations 8 coded responses 31 check-ins 8 free-text entries 3 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
967 / HI
Registered
2021-03-04
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-04
    Registered in v-safe
  2. 2021-03-04
    Dose 1 — Moderna
  3. 2021-03-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-03-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness
    Adult check-in
  5. 2021-03-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness
    Adult check-in
  6. 2021-03-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Joint pains
    Adult check-in
  7. 2021-03-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Diarrhea, Abdominal pain
    Adult check-in
  9. 2021-03-12
    Health check-in — day 7, dose 1
    Feeling: Good · Abdominal pain
    Adult check-in
  10. 2021-03-18
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-27
    Survey response — day 21, dose 1
    MedDRA: Asthma, Hypersensitivity, Pre-existing disease, Rash — Feeling: Good · Be unable to do your normal daily activities
    Free text: Slight skin rash on chest, joint pain but could be fibromyalgia. Allergy symptoms which flares asthma. I get these symptoms off and on intermittently but usually not all at once and onset not so strong. Used meds asthma pump etc.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-01
    Dose 2 — Moderna
  13. 2021-04-15
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-04-22
    Survey response — day 21, dose 2
    MedDRA: Asthma, Balance disorder, Chest discomfort, Fatigue, Medical observation, Pre-existing disease, Respiratory tract congestion, Thrombosis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, Hospitalization
    Free text: Symptoms: Chest tightness, asthma flare, off balance, extreme fatigue, and congestion. · Healthcare visit (other): Observation and testing for blood clot, etc. all were negative
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-22
    Report sent to call center — day 21, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  16. 2021-04-29
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  17. 2021-05-06
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  18. 2021-05-13
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-07-03
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-10-02
    Survey response — 6 months, dose 2
    MedDRA: Muscle spasms — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit
    Free text: Muscle spasms in legs and chest and shoulder
    MedDRA releases: 2024-11 · check-in free text available
  21. 2021-10-02
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
  22. 2021-10-04
  23. 2021-12-18
    Dose 3 — Moderna
  24. 2021-12-18
    Survey response — day 0, dose 3
    MedDRA: Feeling hot — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: Hot but no fever
    MedDRA releases: 2024-11 · check-in free text available
  25. 2021-12-19
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  26. 2021-12-20
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school
    Adult check-in
  27. 2021-12-21
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  28. 2021-12-22
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Diarrhea, Abdominal pain
    Adult check-in
  29. 2021-12-23
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Abdominal pain
    Adult check-in
  30. 2021-12-25
    Health check-in — day 7, dose 3
    Feeling: Good · Headache
    Adult check-in
  31. 2022-01-01
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  32. 2022-01-08
    Survey response — day 21, dose 3
    MedDRA: Respiratory tract congestion, Respiratory tract irritation — Feeling: Good
    Free text: Irritated air passage and congestion
    MedDRA releases: 2024-11 · check-in free text available
  33. 2022-01-15
    Health check-in — day 28, dose 3
    Feeling: Fair
    Adult check-in
  34. 2022-01-22
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  35. 2022-01-29
    Survey response — day 42, dose 3
    MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Covid symptoms, sore throat, congestion etc.
    MedDRA releases: 2024-11 · check-in free text available
  36. 2022-03-19
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  37. 2022-06-18
    Survey response — 6 months, dose 3
    MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Exhausted
    MedDRA releases: 2024-11 · check-in free text available
  38. 2022-12-18
    Survey response — 12 months, dose 3
    MedDRA: COVID-19 — Feeling: Poor · 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
    Free text: Covid
    MedDRA releases: 2024-11 · check-in free text available
  39. 2022-12-18
    Report sent to call center — 12 months, dose 3
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  40. 2022-12-21
  41. 2022-12-21
  42. 2022-12-21
  43. 2022-12-21
    Call successful
    Not applicable - Accidental Reporting
  44. 2022-12-21
    Call successful
    Not applicable - Accidental Reporting
  45. 2022-12-21
    Call successful
    Completed over the phone

Vaccinations

DoseDateManufacturerCo-administered
12021-03-04Moderna
22021-04-01Moderna
32021-12-18Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-04-22 Successful
2022-12-21
 Not applicable - Accidental Reporting
2021-10-02 Successful
2022-12-21
 Not applicable - Accidental Reporting
2022-12-18 Successful
2022-12-21
 Completed over the phone

Free text

Release 6 — day 21, dose 1

2021-03-27

Symptoms: Slight skin rash on chest, joint pain but could be fibromyalgia. Allergy symptoms which flares asthma. I get these symptoms off and on intermittently but usually not all at once and onset not so strong. Used meds asthma pump etc.

Release 7 — day 21, dose 2

2021-04-22

Symptoms: Chest tightness, asthma flare, off balance, extreme fatigue, and congestion.
Healthcare visit (other): Observation and testing for blood clot, etc. all were negative

Release 9 — 6 months, dose 2

2021-10-02

Symptoms: Muscle spasms in legs and chest and shoulder

Release 10 — day 0, dose 3

2021-12-18

Systemic reaction (other): Hot but no fever

Release 10 — day 21, dose 3

2022-01-08

Symptoms: Irritated air passage and congestion

Release 11 — day 42, dose 3

2022-01-29

Symptoms: Covid symptoms, sore throat, congestion etc.

Release 12 — 6 months, dose 3

2022-06-18

Symptoms: Exhausted

Release 12 — 12 months, dose 3

2022-12-18

Symptoms: Covid

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
HCVOMedical observation · · ✓
HCVOThrombosis ✓ ✓ ○
SDAsthma ✓ ✓ ✓
SDBalance disorder · · ✓
SDChest discomfort ✓ ✓ ✓
SDCOVID-19 · · ✓
SDFatigue · · ✓
SDHypersensitivity ✓ ✓ ✓
SDMuscle spasms · · ✓
SDOropharyngeal pain · · ✓
SDPre-existing disease ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDRespiratory tract irritation · · ✓
SROFeeling hot · · ✓

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

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