YRA-10113-91636
4 vaccinations
8 coded responses
44 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 275 / NC
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Registered in v-safe
-
2021-03-17
Dose 1 — Moderna
- 2021-03-17
- 2021-03-18
-
2021-03-19
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-03-20
- 2021-03-21
- 2021-03-22
-
2021-03-23
Survey response — days 1–6 daily, dose 1MedDRA: Nausea — Feeling: GoodFree text: Very low level of nausea yesterday evening. Not typical for me. Happened a few times since the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-31
- 2021-04-07
-
2021-04-14
Dose 2 — Moderna
- 2021-04-14
-
2021-04-15
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-28
- 2021-05-05
-
2021-05-12
Survey response — day 28, dose 2MedDRA: Arthralgia, Muscular weakness, Neuralgia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Sudden joint/nerve pain/weakness in one leg.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-19
Survey response — day 35, dose 2MedDRA: Dizziness — Feeling: Good · Be unable to do your normal daily activitiesFree text: Lightheadedness on one occasion not due to any other identifiable cause and unusual for me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-26
- 2021-07-14
- 2021-10-13
-
2021-11-04
Dose 3 — Moderna
- 2021-11-04
-
2021-11-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-11-06
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, NauseaAdult check-in
-
2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Lower urinary tract symptoms — Feeling: Good · NauseaFree text: Symptoms of UTI last 48 hoursMedDRA releases: 2024-11 · check-in free text available
-
2021-11-08
Survey response — days 1–6 daily, dose 3MedDRA: Lower urinary tract symptoms — Feeling: GoodFree text: Continued UTI symptomsMedDRA releases: 2024-11 · check-in free text available
-
2021-11-09
Survey response — days 1–6 daily, dose 3MedDRA: Lower urinary tract symptoms, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Systemic reaction (other): Evaluated by doctor for possible inflammatory reaction to vaccine resulting in UTI-like symptoms · Healthcare visit (other): Visit with PCPMedDRA releases: 2024-11 · check-in free text available
-
2021-11-09
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-11-10
Call successfulCompleted over the phone
-
2021-11-11
Survey response — day 7, dose 3MedDRA: Unevaluable event — Feeling: Good · Fatigue or tirednessFree text: Still waiting on results of bacteria culture reported previouslyMedDRA releases: 2024-11 · check-in free text available
- 2021-11-20
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-16
-
2022-02-06
Survey response — 3 months, dose 3MedDRA: Dizziness, Palpitations — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Heart palpitations, brief intermittent light headedness.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-06
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-02-08
- 2022-05-07
-
2022-05-24
Dose 4 — Pfizer-BioNTech
- 2022-06-01
- 2022-06-07
- 2022-06-21
- 2022-08-25
- 2022-11-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-14 | Moderna | |
| 3 | 2021-11-04 | Moderna | No |
| 4 | 2022-05-24 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-09 | Successful 2021-11-10 |
Completed over the phone |
| 2022-02-06 | Unsuccessful |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Very low level of nausea yesterday evening. Not typical for me. Happened a few times since the shot.
Release 8 — day 28, dose 2
Symptoms: Sudden joint/nerve pain/weakness in one leg.
Release 8 — day 35, dose 2
Symptoms: Lightheadedness on one occasion not due to any other identifiable cause and unusual for me.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Symptoms of UTI last 48 hours
Systemic reaction (other): Continued UTI symptoms
Systemic reaction (other): Evaluated by doctor for possible inflammatory reaction to vaccine resulting in UTI-like symptoms
Healthcare visit (other): Visit with PCP
Release 10 — day 7, dose 3
Systemic reaction (other): Still waiting on results of bacteria culture reported previously
Release 11 — 3 months, dose 3
Symptoms: Heart palpitations, brief intermittent light headedness.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Muscular weakness | ✓ | ✓ | ✓ |
| SD | Neuralgia | ✓ | ✓ | ✓ |
| SD | Palpitations | · | · | ✓ |
| SRO | Lower urinary tract symptoms | · | · | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Office visit | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release