YPH-21961-82651
3 vaccinations
7 coded responses
30 check-ins
7 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 615 / IL
- Registered
- 2021-01-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Registered in v-safe
-
2021-01-19
Dose 1 — Moderna
-
2021-01-21
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: Good · Site: Pain · Headache, Fatigue or tirednessFree text: These symptoms may not be related as I get headaches anyway sometimes and dont always sleep wellMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-02-02
- 2021-02-09
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2021-02-16
Survey response — day 28, dose 1MedDRA: Ear discomfort, Nasal congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Stuffy/runny nose. Ears plugged. Had a Covid test as a precaution. Was negative. Likely cold symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-16
Report sent to call center — day 28, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-18
Dose 2 — Moderna
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
-
2021-05-20
Survey response — 3 months, dose 2MedDRA: Nasopharyngitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cold symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-20
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-16
-
2021-06-22
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-08-19
-
2021-10-22
Dose 3 — Moderna
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Formication, Headache, Pain, Pain in extremity — Feeling: GoodFree text: After booster-The next day, I had a headache, sore body/arm, and crawling skin feelingMedDRA releases: 2024-11 · check-in free text available
- 2021-10-27
- 2021-10-29
- 2021-11-05
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2021-11-12
Survey response — day 21, dose 3MedDRA: Fatigue, Headache, Throat irritation — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Headaches, fatigue, scratchy throatMedDRA releases: 2024-11 · check-in free text available
-
2021-11-12
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-15
-
2021-11-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-20
- 2021-11-27
- 2021-12-03
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2022-01-21
Survey response — 3 months, dose 3MedDRA: COVID-19, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, HospitalizationFree text: Symptoms: I had Covid recently · Healthcare visit (other): Doctor apptMedDRA releases: 2024-11 · check-in free text available
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2022-01-21
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Hospitalization · 1 call case(s)
- 2022-01-24
-
2022-01-26
Call successfulDoes not wish to fill out VAERS report
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2022-04-24
Survey response — 6 months, dose 3MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: I had covid. I believe this was since the last check in?MedDRA releases: 2024-11 · check-in free text available
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2022-04-24
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-18 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-16 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-05-20 | Successful 2021-06-22 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-11-12 | Successful 2021-11-15 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-01-21 | Successful 2022-01-26 |
Does not wish to fill out VAERS report |
| 2022-04-24 | Successful 2022-04-25 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): These symptoms may not be related as I get headaches anyway sometimes and dont always sleep well
Release 4 — day 28, dose 1
Symptoms: Stuffy/runny nose. Ears plugged. Had a Covid test as a precaution. Was negative. Likely cold symptoms
Release 8 — 3 months, dose 2
Symptoms: Cold symptoms
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): After booster-The next day, I had a headache, sore body/arm, and crawling skin feeling
Release 10 — day 21, dose 3
Symptoms: Headaches, fatigue, scratchy throat
Release 11 — 3 months, dose 3
Release 11 — 6 months, dose 3
Symptoms: I had covid. I believe this was since the last check in?
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 | Office visit | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ear discomfort | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Formication | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release