YSJ-15914-65484
2 vaccinations
2 coded responses
17 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 100 / NY
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-16
Registered in v-safe
-
2021-01-16
Dose 1 — Moderna
- 2021-01-16
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Itching · Fever · HeadacheAdult check-in
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-23
- 2021-01-30
- 2021-02-13
-
2021-02-14
Dose 2 — Moderna
- 2021-02-20
- 2021-02-21
- 2021-02-28
- 2021-03-07
- 2021-03-21
- 2021-03-30
-
2021-05-16
Survey response — 3 months, dose 2MedDRA: Heart rate increased — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Runs of high heart rateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-16
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-17
-
2022-02-13
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-02-14
Survey response — 12 months, dose 2MedDRA: Swelling, Urticaria — 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, Emergency room or emergency department visitFree text: Chronic hives with swellingMedDRA releases: 2024-11 · check-in free text available
-
2022-02-14
Report sent to call center — 12 months, dose 2Be 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 · Emergency room or emergency department visit · 1 call case(s)
- 2022-02-15
- 2022-02-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-14 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-16 | Successful 2022-02-13 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-02-14 | Unsuccessful |
Free text
Release 8 — 3 months, dose 2
Symptoms: Runs of high heart rate
Release 11 — 12 months, dose 2
Symptoms: Chronic hives with swelling
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 |
|---|---|---|---|---|
| SD | Heart rate increased | ✓ | ✓ | ✓ |
| SD | Swelling | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release