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YP9-20734-37540

3 vaccinations 4 coded responses 11 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
920 / CA
Registered
2021-03-05
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-04
    Dose 1 — Moderna
  2. 2021-03-05
    Registered in v-safe
  3. 2021-03-05
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  4. 2021-03-06
    Dose 2 — Moderna
  5. 2021-03-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  6. 2021-03-15
    Survey response — day 7, dose 2
    MedDRA: No adverse event — Feeling: Good
    Free text: No
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-20
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  8. 2021-03-29
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-04-04
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-04-12
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-04-19
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-09-08
    Survey response — 6 months, dose 2
    MedDRA: Cystitis, Malaise — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Got a bladder infection and have just felt kinda sickly for couple weeks.
    MedDRA releases: 2024-11 · check-in free text available
  13. 2021-11-09
    Dose 3 — Moderna
  14. 2022-03-08
    Survey response — 12 months, dose 2
    MedDRA: Asthenia, Cardiac disorder, Heart rate increased, Heart rate irregular, Hypotension, Malaise, Office visit, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: I have been having some heart problems like irregular heartbeat high and low blood pressure and just a feeling of not feeling well. I do take heart medication and I have a pacemaker. I have very low energy since my booster shot. · Healthcare visit (other): Office visit with heart Dr
    MedDRA releases: 2024-11 · check-in free text available
  15. 2022-03-08
    Report sent to call center — 12 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  16. 2022-03-10
  17. 2022-11-09
    Survey response — 12 months, dose 3
    MedDRA: COVID-19, Insomnia, Malaise, Pyrexia, SARS-CoV-2 test positive, Somnolence — Feeling: Fair · 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: Got Covid Nov 2 was really sick with 102 temp for 2 days. Have improved considerably but still testing positive. Slept for those two days but having hard time sleeping ever since. No prob with breathing.
    MedDRA releases: 2024-11 · check-in free text available
  18. 2022-11-09
    Report sent to call center — 12 months, dose 3
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  19. 2022-11-10
  20. 2022-11-10

Vaccinations

DoseDateManufacturerCo-administered
12021-02-04Moderna
22021-03-06Moderna
32021-11-09Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2022-03-08 Unsuccessful
2022-11-09 Unsuccessful

Free text

Release 5 — day 7, dose 2

2021-03-15

Systemic reaction (other): No

Release 9 — 6 months, dose 2

2021-09-08

Symptoms: Got a bladder infection and have just felt kinda sickly for couple weeks.

Release 11 — 12 months, dose 2

2022-03-08

Symptoms: I have been having some heart problems like irregular heartbeat high and low blood pressure and just a feeling of not feeling well. I do take heart medication and I have a pacemaker. I have very low energy since my booster shot.
Healthcare visit (other): Office visit with heart Dr

Release 12 — 12 months, dose 3

2022-11-09

Symptoms: Got Covid Nov 2 was really sick with 102 temp for 2 days. Have improved considerably but still testing positive. Slept for those two days but having hard time sleeping ever since. No prob with breathing.

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 · · ✓
SDAsthenia · · ✓
SDCardiac disorder · · ✓
SDCOVID-19 · · ✓
SDCystitis · · ✓
SDHeart rate increased · · ✓
SDHeart rate irregular · · ✓
SDHypotension · · ✓
SDInsomnia · · ✓
SDMalaise · · ✓
SDPre-existing disease · · ✓
SDPyrexia · · ✓
SDSARS-CoV-2 test positive · · ✓
SDSomnolence · · ✓
SRONo adverse event ✓ ✓ ✓

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