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YPH-29954-04517

3 vaccinations 6 coded responses 32 check-ins 6 free-text entries 3 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
066 / CT
Registered
2021-02-17
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-17
    Registered in v-safe
  2. 2021-02-17
    Dose 1 — Moderna
  3. 2021-02-17
    Health check-in — day 0, dose 1
    Feeling: Good · Headache
    Adult check-in
  4. 2021-02-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  5. 2021-02-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Muscle or body aches
    Adult check-in
  7. 2021-02-21
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pre-existing disease — Feeling: Good
    Free text: Ongoing low back/bilateral hip pain onset prior to vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-23
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthralgia, Back pain — Feeling: Good
    Free text: Pre vaccine low back/bilateral hip pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-24
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-03
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-10
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-03-17
    Dose 2 — Moderna
  13. 2021-03-24
    Health check-in — day 7, dose 2
    Feeling: Fair · Muscle or body aches, Diarrhea, Abdominal pain
    Adult check-in
  14. 2021-03-31
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-04-06
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-04-07
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-04-14
    Survey response — day 28, dose 2
    MedDRA: Lymphadenopathy, Medical counselling, Oropharyngeal discomfort — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Swollen gland left side neck with throat discomfort. · Healthcare visit (other): Phone call tobPCP
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-14
    Report sent to call center — day 28, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  19. 2021-04-28
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-06-16
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-09-15
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-12-06
    Dose 3 — Moderna
  23. 2021-12-07
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches
    Adult check-in
  24. 2021-12-08
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · Muscle or body aches
    Adult check-in
  25. 2021-12-09
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Headache, Joint pains
    Adult check-in
  26. 2021-12-10
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Itching · Muscle or body aches
    Adult check-in
  27. 2021-12-11
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Itching · Headache
    Adult check-in
  28. 2021-12-12
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Itching · None
    Adult check-in
  29. 2021-12-13
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  30. 2021-12-20
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  31. 2021-12-27
    Survey response — day 21, dose 3
    MedDRA: Electric shock sensation, Pain — Feeling: Fair
    Free text: Sporadic flashes of electric type pain in different areas of body.
    MedDRA releases: 2024-11 · check-in free text available
  32. 2022-01-03
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  33. 2022-01-10
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  34. 2022-01-17
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  35. 2022-02-22
  36. 2022-03-08
    Survey response — 3 months, dose 3
    MedDRA: Office visit, Oropharyngeal discomfort, SARS-CoV-2 test negative, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: One sided throat discomfort from mid January; went for PCR test 1/26, negative for Covid. Consult w/ENT 3/7, nothing of note; most likely reflux related · Healthcare visit (other): Consult ENT
    MedDRA releases: 2024-11 · check-in free text available
  37. 2022-03-08
    Report sent to call center — 3 months, dose 3
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  38. 2022-03-11
  39. 2022-06-08
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  40. 2022-12-08
    Survey response — 12 months, dose 3
    MedDRA: Condition aggravated, Muscle strain, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: L shoulder strain from overuse to an area previously injured in lifting 3/2015
    MedDRA releases: 2024-11 · check-in free text available
  41. 2022-12-08
    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
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  42. 2022-12-09
  43. 2022-12-09
  44. 2022-12-09

Vaccinations

DoseDateManufacturerCo-administered
12021-02-17Moderna
22021-03-17Moderna
32021-12-06Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-04-14 Unsuccessful
2022-03-08 Unsuccessful
2022-12-08 Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-21

Systemic reaction (other): Ongoing low back/bilateral hip pain onset prior to vaccine

2021-02-23

Systemic reaction (other): Pre vaccine low back/bilateral hip pain

Release 7 — day 28, dose 2

2021-04-14

Symptoms: Swollen gland left side neck with throat discomfort.
Healthcare visit (other): Phone call tobPCP

Release 10 — day 21, dose 3

2021-12-27

Symptoms: Sporadic flashes of electric type pain in different areas of body.

Release 11 — 3 months, dose 3

2022-03-08

Symptoms: One sided throat discomfort from mid January; went for PCR test 1/26, negative for Covid. Consult w/ENT 3/7, nothing of note; most likely reflux related
Healthcare visit (other): Consult ENT

Release 12 — 12 months, dose 3

2022-12-08

Symptoms: L shoulder strain from overuse to an area previously injured in lifting 3/2015

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
HCVOMedical counselling ✓ ✓ ✓
HCVOUnevaluable event · · ✓
SDCondition aggravated · · ✓
SDElectric shock sensation · · ✓
SDLymphadenopathy ✓ ✓ ✓
SDMuscle strain · · ✓
SDOffice visit · · ✓
SDOropharyngeal discomfort ✓ ✓ ✓
SDPain · · ✓
SDPre-existing disease · · ✓
SDSARS-CoV-2 test negative · · ✓
SROArthralgia ✓ ✓ ✓
SROBack pain ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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