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YR5-86387-84687

3 vaccinations 5 coded responses 20 check-ins 5 free-text entries 2 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
125 / NY
Registered
2021-01-07
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-06
    Dose 1 — Moderna
  2. 2021-01-07
    Registered in v-safe
  3. 2021-01-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness
    Adult check-in
  4. 2021-01-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  5. 2021-01-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Diarrhoea, Flatulence — Feeling: Good · Diarrhea, Abdominal pain
    Free text: I've had diarrhea and gas pain since the day after injection 1. I did not correlate it to the vaccine but a week later and I still have the same symptoms.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Diarrhea
    Adult check-in
  8. 2021-01-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-13
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-22
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-01-27
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-03
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-04
    Dose 2 — Moderna
  14. 2021-02-17
    Survey response — day 7, dose 2
    MedDRA: Fatigue, Pain — Feeling: Good · Be unable to work, Be unable to do your normal daily activities
    Free text: I had bad fatigue & body aches the day after my 2nd dose
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-18
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-02-25
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-03-04
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-11
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-03-18
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-04-15
    Pregnancy registry survey
    Not pregnant at or since vaccination ·
  21. 2021-05-06
    Survey response — 3 months, dose 2
    MedDRA: Heavy menstrual bleeding, Office visit, Pain in extremity — 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, Outpatient clinic or urgent care clinic visit
    Free text: Left leg pain. Had a scan to look for blood clots. It was negative. Also very heavy periods. Seeing a dr about that now.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-05-06
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  23. 2021-06-08
  24. 2021-08-07
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-12-14
    Dose 3 — Moderna
  26. 2022-02-04
    Survey response — 12 months, dose 2
    MedDRA: Chest pain, Emergency care — 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 · Emergency room or emergency department visit
    Free text: After my booster I had severe chest pains and went to the emergency room.
    MedDRA releases: 2024-11 · check-in free text available
  27. 2022-02-04
    Report sent to call center — 12 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Emergency room or emergency department visit · 1 call case(s)
  28. 2022-02-08
    Call successful
    Participant prefers to complete VAERS report online
  29. 2022-12-14
    Survey response — 12 months, dose 3
    MedDRA: Gallbladder disorder, Migraine, Muscle spasms — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Migraines, gallbladder issues, muscles spasms
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-06Moderna
22021-02-04Moderna
32021-12-14Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-05-06 Successful Participant prefers to complete VAERS report online
2022-02-04 Successful
2022-02-08
Participant prefers to complete VAERS report online

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): I've had diarrhea and gas pain since the day after injection 1. I did not correlate it to the vaccine but a week later and I still have the same symptoms.

Release 4 — day 7, dose 2

2021-02-17

Systemic reaction (other): I had bad fatigue & body aches the day after my 2nd dose

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: Left leg pain. Had a scan to look for blood clots. It was negative. Also very heavy periods. Seeing a dr about that now.

Release 11 — 12 months, dose 2

2022-02-04

Symptoms: After my booster I had severe chest pains and went to the emergency room.

Release 12 — 12 months, dose 3

2022-12-14

Symptoms: Migraines, gallbladder issues, muscles spasms

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
SDChest pain · · ✓
SDEmergency care · · ✓
SDGallbladder disorder · · ✓
SDHeavy menstrual bleeding ✓ ✓ ✓
SDMigraine · · ✓
SDMuscle spasms · · ✓
SDOffice visit ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SRODiarrhoea ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROFlatulence ✓ ✓ ✓
SROPain ✓ ✓ ✓

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