YQ5-16927-32872
4 vaccinations
5 coded responses
37 check-ins
5 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 981 / WA
- Registered
- 2020-12-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-27
Dose 1 — Moderna
-
2020-12-29
Registered in v-safe
- 2020-12-29
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
-
2021-01-24
Dose 2 — Moderna
- 2021-01-24
-
2021-01-25
Survey response — days 1–6 daily, dose 2MedDRA: Chills — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Chills were very severe and lasted about 30 minMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-26
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema, Injection site warmth, SARS-CoV-2 test — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Systemic reaction (other): A phlebitis below vaccination site. Getting larger, not swollen warm to touch, bright red · Healthcare visit (other): Got covid tested today made appointment with MDMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-26
Report sent to call center — days 1–6 daily, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-01-27
Survey response — days 1–6 daily, dose 2MedDRA: Phlebitis — Feeling: Good · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site · Be unable to workFree text: More like a phlebitis than rashMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
-
2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-01-31
- 2021-02-07
- 2021-02-14
- 2021-02-21
- 2021-02-28
- 2021-03-07
- 2021-04-25
- 2021-06-07
- 2021-07-25
-
2021-10-23
Dose 3 — Pfizer-BioNTech
- 2021-10-29
- 2021-11-08
- 2021-11-13
- 2021-11-22
- 2021-11-27
- 2021-12-04
- 2022-01-22
- 2022-04-23
-
2022-05-20
Dose 4 — Moderna
- 2022-05-22
- 2022-05-26
- 2022-05-27
- 2022-06-05
- 2022-06-10
- 2022-06-19
- 2022-06-26
- 2022-07-01
-
2022-08-19
Survey response — 3 months, dose 4MedDRA: COVID-19, Diarrhoea, Hospitalisation, Malaise, Pain, Pulmonary embolism, Pulmonary thrombosis, Pyrexia, Salmonellosis, Thrombosis — 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 · Emergency room or emergency department visit, HospitalizationFree text: COVID on 7/31. High fevers, body aches, diarrhea. Also got salmonella was very sick hospitalized for blood clots right lower extremity. Multiple blood clots at bases of lungs and bilateral PUlmonary embolism.MedDRA releases: 2024-11 · check-in free text available
-
2022-08-19
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-08-22
- 2022-08-22
-
2022-11-19
Survey response — 6 months, dose 4MedDRA: Diarrhoea, Headache, Malaise, Pulmonary embolism, Pulmonary thrombosis, Pyrexia, SARS-CoV-2 test positive, Salmonellosis, Thrombosis — 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 visit, Emergency room or emergency department visit, HospitalizationFree text: Not sure I documented a positive covid test August 1, 2022. Became very sick with high fevers, headaches and diarrhea. I had also salmonella at the time. Had blood clots in right leg and lungs with bilateral lung Pulmonary Embolism.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-19
Report sent to call center — 6 months, dose 4Be 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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-11-21
- 2022-11-21
- 2022-11-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-27 | Moderna | |
| 2 | 2021-01-24 | Moderna | |
| 3 | 2021-10-23 | Pfizer-BioNTech | No |
| 4 | 2022-05-20 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-26 | Unsuccessful | |
| 2022-08-19 | Unsuccessful | |
| 2022-11-19 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Chills were very severe and lasted about 30 min
Systemic reaction (other): A phlebitis below vaccination site. Getting larger, not swollen warm to touch, bright red
Healthcare visit (other): Got covid tested today made appointment with MD
Systemic reaction (other): More like a phlebitis than rash
Release 12 — 3 months, dose 4
Symptoms: COVID on 7/31. High fevers, body aches, diarrhea. Also got salmonella was very sick hospitalized for blood clots right lower extremity. Multiple blood clots at bases of lungs and bilateral PUlmonary embolism.
Release 12 — 6 months, dose 4
Symptoms: Not sure I documented a positive covid test August 1, 2022. Became very sick with high fevers, headaches and diarrhea. I had also salmonella at the time. Had blood clots in right leg and lungs with bilateral lung Pulmonary Embolism.
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 | SARS-CoV-2 test | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pulmonary embolism | · | · | ✓ |
| SD | Pulmonary thrombosis | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Salmonellosis | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Thrombosis | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Phlebitis | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release