YMJ-27971-91639
1 vaccination
7 coded responses
12 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 060 / CT
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-25
Dose 1 — Moderna
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2021-02-27
Registered in v-safe
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2021-02-27
Survey response — days 1–6 daily, dose 1MedDRA: Altered state of consciousness, Hyperhidrosis, Neuralgia — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · 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: Morning after the vaccine I woke up and everything in front of me went black when I stood up. I was struggling to stay conscious and diaphoretic. I could not stand up on my own. This happened three times in an hour. I am now experiencing neuralgia, as well.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-27
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-28
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Pain — Feeling: Good · Site: PainFree text: Shooting pains in headMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Pain — Feeling: Good · Site: PainFree text: Shooting pains in headMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-02
Survey response — days 1–6 daily, dose 1MedDRA: Palpitations — Feeling: GoodFree text: Heart palpitationsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Injection site reaction — Feeling: Fair · Fatigue or tirednessFree text: Arm where injection was given just didnt feel right. Feels OK nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Survey response — day 7, dose 1MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Pain in arm, hand, and fingers (this is the arm where injection occurred)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site rash — 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: Large red and elevated rash at injection sight. Started at Day 8 after injection. Area is currently hyperpigmentedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Report sent to call center — day 14, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-05-27
- 2021-12-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-27 | Unsuccessful | |
| 2021-03-11 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Morning after the vaccine I woke up and everything in front of me went black when I stood up. I was struggling to stay conscious and diaphoretic. I could not stand up on my own. This happened three times in an hour. I am now experiencing neuralgia, as well.
Systemic reaction (other): Shooting pains in head
Systemic reaction (other): Shooting pains in head
Systemic reaction (other): Heart palpitations
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Arm where injection was given just didnt feel right. Feels OK now
Release 5 — day 7, dose 1
Systemic reaction (other): Pain in arm, hand, and fingers (this is the arm where injection occurred)
Release 5 — day 14, dose 1
Symptoms: Large red and elevated rash at injection sight. Started at Day 8 after injection. Area is currently hyperpigmented
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 | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Altered state of consciousness | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Injection site reaction | ✓ | ✓ | ✓ |
| SRO | Neuralgia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release