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YL9-24468-09094

2 vaccinations 5 coded responses 18 check-ins 5 free-text entries 1 call case
Sex
Female
Age at first dose
56-60
ZIP prefix
240 / VA
Registered
2021-03-10
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-09
    Dose 1 — Moderna
  2. 2021-03-10
    Registered in v-safe
  3. 2021-03-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  4. 2021-03-11
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pain in extremity — Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Free text: Pain in an area about three inches above where I received the injection.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  6. 2021-03-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: I am feeling back to the way I was before I received the vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-03-16
    Health check-in — day 7, dose 1
    Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  9. 2021-03-23
    Survey response — day 14, dose 1
    MedDRA: Ear infection, Ear pain, Facial pain, Headache, Nasopharyngitis, Pyrexia, Sinus disorder — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Yes, I feel like I have a bad cold with possible sinus and ear infection - honestly, facial pain, ear pain, headache, mild fever.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-01
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  11. 2021-04-06
    Health check-in — day 28, dose 1
    Feeling: Fair
    Adult check-in
  12. 2021-04-08
    Dose 2 — Moderna
  13. 2021-04-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness
    Free text: I started having a reaction to the vaccine within 5 minutes. For two days I felt very sick.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-15
    Health check-in — day 7, dose 2
    Feeling: Fair · Site: Pain · None
    Adult check-in
  15. 2021-04-24
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-04-29
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  17. 2021-05-06
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-05-20
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  19. 2021-07-08
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  20. 2021-10-07
    Survey response — 6 months, dose 2
    MedDRA: Ear infection, Nasopharyngitis, Office visit, Sinusitis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Sinus infection, ear infection, bad cold · Healthcare visit (other): My primary physician in her office.
    MedDRA releases: 2024-11 · check-in free text available
  21. 2021-10-07
    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
    1 call case(s)
  22. 2021-12-06
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  23. 2022-04-08
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-09Moderna
22021-04-08Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-10-07 Successful
2021-12-06
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-11

Systemic reaction (other): Pain in an area about three inches above where I received the injection.

2021-03-14

Systemic reaction (other): I am feeling back to the way I was before I received the vaccine.

Release 6 — day 14, dose 1

2021-03-23

Symptoms: Yes, I feel like I have a bad cold with possible sinus and ear infection - honestly, facial pain, ear pain, headache, mild fever.

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): I started having a reaction to the vaccine within 5 minutes. For two days I felt very sick.

Release 10 — 6 months, dose 2

2021-10-07

Symptoms: Sinus infection, ear infection, bad cold
Healthcare visit (other): My primary physician in her office.

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
HCVOOffice visit · · ✓
SDEar infection ✓ ✓ ✓
SDEar pain ✓ ✓ ✓
SDFacial pain ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDNasopharyngitis ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDSinus disorder ✓ ✓ ✓
SDSinusitis · · ✓
SROImmunisation reaction ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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