YM8-16833-76661
6 vaccinations
8 coded responses
74 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 027 / MA
- Registered
- 2021-02-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-28
Registered in v-safe
-
2021-03-01
Dose 1 — Moderna
- 2021-03-01
-
2021-03-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
-
2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Rash, Rash pruritic — Feeling: GoodFree text: last evening an itchy rash on lower inside of my arm, not near injection site but on the same arm, seems better 12 hours laterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-03-15
-
2021-03-22
Survey response — day 21, dose 1MedDRA: Erythema, Rash — Feeling: GoodFree text: on 3/1 I had my first dose (in left arm) and I've been fine other than a small rash on my lower left arm which was gone within 24 hours. I then had a small 1/2x3/8 square that looked like broken blood vessels no pain and it is healing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-29
Dose 2 — Moderna
- 2021-03-29
-
2021-03-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Fatigue or tirednessAdult check-in
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-06-28
- 2021-09-27
-
2021-10-25
Dose 3 — Moderna
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-18
Dose 4 — Moderna
- 2022-04-18
-
2022-04-19
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-20
-
2022-04-21
Survey response — days 1–6 daily, dose 4MedDRA: Exposure to SARS-CoV-2, SARS-CoV-2 test negative — Feeling: GoodFree text: My husband has rapid tested positive for covid, mine is negative but going for PCR test tomorrow.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-22
-
2022-04-23
Survey response — days 1–6 daily, dose 4MedDRA: Cough — Feeling: GoodFree text: Still waiting for PCR results but other than a slight cough I'm feeling fine and it could be allergies.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-24
- 2022-04-25
-
2022-05-02
Survey response — day 14, dose 4MedDRA: Chills, Cough, Diarrhoea, Rhinorrhoea, SARS-CoV-2 test positive, Unevaluable event, Vomiting — 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 consultationFree text: Symptoms: I tested positive for covid on Monday, 4/25, I never had a fever, but i had the following symptoms, runny nose, cough, diarrhea, vomiting, and chills. I have been on Paxlovid and almost done. I don't think the vaccine interfered with my symptoms. · Healthcare visit (other): Test done 4/25 results on 4/26MedDRA releases: 2024-11 · check-in free text available
-
2022-05-02
Report sent to call center — day 14, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-05-03
Call successfulCompleted over the phone
- 2022-05-09
- 2022-05-16
- 2022-05-23
- 2022-05-30
-
2022-07-18
Survey response — 3 months, dose 4MedDRA: Nasopharyngitis — Feeling: GoodFree text: Just a summer cold continually testing negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-09-30
Dose 5 — Moderna
- 2022-09-30
- 2022-10-01
- 2022-10-02
- 2022-10-03
- 2022-10-04
- 2022-10-05
- 2022-10-06
- 2022-10-08
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-11-11
-
2022-12-30
Survey response — 3 months, dose 5MedDRA: SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Have had an upper respiratory infection but my PCR was negative for Covid.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-30
Report sent to call center — 3 months, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2023-01-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-03-31
-
2023-05-01
Dose 6 — Moderna
- 2023-05-01
- 2023-05-03
- 2023-05-04
- 2023-05-05
- 2023-05-10
- 2023-05-15
- 2023-05-22
- 2023-05-29
- 2023-06-05
-
2023-06-12
Survey response — day 42, dose 6MedDRA: Nasopharyngitis, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-01 | Moderna | |
| 2 | 2021-03-29 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-18 | Moderna | No |
| 5 | 2022-09-30 | Moderna | No |
| 6 | 2023-05-01 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-02 | Successful 2022-05-03 |
Completed over the phone |
| 2022-12-30 | Successful 2023-01-03 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): last evening an itchy rash on lower inside of my arm, not near injection site but on the same arm, seems better 12 hours later
Release 6 — day 21, dose 1
Symptoms: on 3/1 I had my first dose (in left arm) and I've been fine other than a small rash on my lower left arm which was gone within 24 hours. I then had a small 1/2x3/8 square that looked like broken blood vessels no pain and it is healing.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): My husband has rapid tested positive for covid, mine is negative but going for PCR test tomorrow.
Systemic reaction (other): Still waiting for PCR results but other than a slight cough I'm feeling fine and it could be allergies.
Release 11 — day 14, dose 4
Symptoms: I tested positive for covid on Monday, 4/25, I never had a fever, but i had the following symptoms, runny nose, cough, diarrhea, vomiting, and chills. I have been on Paxlovid and almost done. I don't think the vaccine interfered with my symptoms. cut off by CDC
Healthcare visit (other): Test done 4/25 results on 4/26
Release 12 — 3 months, dose 4
Symptoms: Just a summer cold continually testing negative.
Release 12 — 3 months, dose 5
Symptoms: Have had an upper respiratory infection but my PCR was negative for 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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Exposure to SARS-CoV-2 | · | · | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test negative | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release