YP9-18317-09953
3 vaccinations
3 coded responses
16 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 119 / NY
- Registered
- 2021-03-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-22
Dose 1 — Moderna
-
2021-03-23
Registered in v-safe
- 2021-03-23
-
2021-03-24
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Joint pains, Muscle or body achesAdult check-in
-
2021-03-26
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: PainFree text: Question! I had made an appointment for my initial dose on 4/18 but got it on 3/15 at (b)(6) NY as a walk-in. My card says I should get dose #2 on 4/19. Is it okay to get it a day earlier and keep my 4/18 appointment at the (b)(6) location?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-28
- 2021-03-31
- 2021-04-05
- 2021-04-12
-
2021-04-18
Dose 2 — Moderna
- 2021-04-26
- 2021-05-02
-
2021-05-09
Survey response — day 21, dose 2MedDRA: Arthralgia, Pre-existing disease — Feeling: GoodFree text: Left hip pain. Had bilateral hip replacement in 2013. Assume this is irrelevant in your line of questioning about COVID, but if its not, let me know! ThanksMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-16
- 2021-05-24
- 2021-06-01
- 2021-07-18
- 2021-10-17
-
2021-12-07
Dose 3 — Moderna
-
2022-04-18
Survey response — 12 months, dose 2MedDRA: Anxiety, Hypertension, Seasonal allergy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Severe hay fever. Also high blood pressure / anxiety situation, received an EKG. Then had bloodwork done 3/30/22.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-18
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-19
-
2022-04-20
Callback requested for11:10AM ET
- 2022-04-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-22 | Moderna | |
| 2 | 2021-04-18 | Moderna | |
| 3 | 2021-12-07 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-18 | Unsuccessful |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Question! I had made an appointment for my initial dose on 4/18 but got it on 3/15 at (b)(6) NY as a walk-in. My card says I should get dose #2 on 4/19. Is it okay to get it a day earlier and keep my 4/18 appointment at the (b)(6) location?
redacted (b)(6)
Release 8 — day 21, dose 2
Symptoms: Left hip pain. Had bilateral hip replacement in 2013. Assume this is irrelevant in your line of questioning about COVID, but if its not, let me know! Thanks
Release 11 — 12 months, dose 2
Symptoms: Severe hay fever. Also high blood pressure / anxiety situation, received an EKG. Then had bloodwork done 3/30/22.
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 | Anxiety | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Seasonal allergy | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release