YRL-40857-32115
4 vaccinations
6 coded responses
47 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 850 / AZ
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Moderna
- 2021-01-12
-
2021-01-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-01-14
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-26
- 2021-02-02
-
2021-02-09
Dose 2 — Moderna
- 2021-02-09
-
2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Sinus headache — Feeling: Fair · Fatigue or tirednessFree text: Sinus headache, not relatedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-24
- 2021-03-04
- 2021-03-10
-
2021-03-29
Survey response — day 42, dose 2MedDRA: Ear infection — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Ear infection. Unrelated to injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-11
- 2021-08-11
-
2021-12-17
Dose 3 — Moderna
- 2021-12-18
-
2021-12-19
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-12-20
- 2021-12-21
- 2021-12-22
- 2021-12-23
- 2021-12-24
- 2021-12-31
- 2022-01-07
- 2022-01-14
- 2022-01-21
-
2022-01-28
Survey response — day 42, dose 3MedDRA: Cough, Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea — Feeling: FairFree text: Cold-like stuffy head & coughing. Clear nasal discharge only.MedDRA releases: 2024-11 · check-in free text available
- 2022-03-18
-
2022-06-11
Dose 4 — Moderna
- 2022-06-17
- 2022-06-17
- 2022-06-18
- 2022-06-25
-
2022-07-02
Survey response — day 21, dose 4MedDRA: Abdominal discomfort, Arthralgia, Herpes zoster, Neck pain, Office visit, Pain in extremity, Pruritus, Pyrexia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Itching, pain on right side of neck down to shoulder and upper arm. Also sporadic fever & upset stomach. · Healthcare visit (other): Appt at primary care. Diagnosed as Shingles despite innoculation 8-10 years ago.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-02
Report sent to call center — day 21, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-07-05
- 2022-07-09
-
2022-07-16
Survey response — day 35, dose 4MedDRA: Diarrhoea, Fatigue, Headache, Vomiting — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Headache, vomiting, diarrhea, fatigue.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-23
-
2022-09-10
Survey response — 3 months, dose 4MedDRA: Diarrhoea, Dizziness postural, Fatigue, Headache, Hyperhidrosis, Nausea — Feeling: Poor · 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 consultationFree text: Headache, nausea, diarrhea, fatigue, sweating(no measurable fever), dizziness when standing.MedDRA releases: 2024-11 · check-in free text available
-
2022-09-10
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 prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-09-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-09-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-12-10
- 2023-06-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-09 | Moderna | |
| 3 | 2021-12-17 | Moderna | No |
| 4 | 2022-06-11 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-02 | Successful 2022-09-13 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-09-10 | Successful 2022-09-13 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Sinus headache, not related
Release 6 — day 42, dose 2
Symptoms: Ear infection. Unrelated to injection.
Release 11 — day 42, dose 3
Symptoms: Cold-like stuffy head & coughing. Clear nasal discharge only.
Release 12 — day 21, dose 4
Symptoms: Itching, pain on right side of neck down to shoulder and upper arm. Also sporadic fever & upset stomach.
Healthcare visit (other): Appt at primary care. Diagnosed as Shingles despite innoculation 8-10 years ago.
Release 12 — day 35, dose 4
Symptoms: Headache, vomiting, diarrhea, fatigue.
Release 12 — 3 months, dose 4
Symptoms: Headache, nausea, diarrhea, fatigue, sweating(no measurable fever), dizziness when standing.
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 | Herpes zoster | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Abdominal discomfort | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dizziness postural | · | · | ✓ |
| SD | Ear infection | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hyperhidrosis | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Sinus headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release