YVK-17155-98851
5 vaccinations
10 coded responses
65 check-ins
10 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 980 / WA
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Registered in v-safe
-
2021-03-11
Dose 1 — Moderna
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2021-03-11
Survey response — day 0, dose 1MedDRA: Hypoaesthesia oral, Paraesthesia oral, Pharyngeal swelling — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Numb lips. Tingle on tip of my tongue, slight throat swellingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Anaphylactic reaction — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Still treating yesterdays's mild anaphylactic reactionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
-
2021-03-18
Survey response — day 7, dose 1MedDRA: Feeling hot, Skin irritation — Feeling: Good · Muscle or body achesFree text: Arm i got shot in feels warm or irritated when i rub it, noth yestetday and todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
- 2021-04-01
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2021-04-08
Dose 2 — Moderna
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2021-04-08
Survey response — day 0, dose 2MedDRA: Self-medication, Swollen tongue — Feeling: Fair · Site: Pain · Chills, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Took Benadryl 20 min before shot. Still have some to tongue swellingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-12
- 2021-04-13
- 2021-04-14
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2021-04-15
Survey response — day 7, dose 2MedDRA: Feeling hot — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activitiesFree text: On side I got vaccinated my shoulder and neck started feeling real warm when putting dishes in cupboardMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-22
- 2021-04-29
- 2021-05-06
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2021-05-13
Survey response — day 35, dose 2MedDRA: Inflammation, Pain — Feeling: GoodFree text: 20 min after some repetitive movement I felt inflammation in the same spot down my arm all the way across shoulder and up neck as when I got second shot. It hurt but not as bad as day I got shot. It was about 10 seconds longMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-20
- 2021-07-08
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2021-10-07
Survey response — 6 months, dose 2MedDRA: Arthritis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Arthritis in thumbMedDRA releases: 2024-11 · check-in free text available
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2021-10-07
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-12
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2021-10-12
Call successfulParticipant prefers to complete VAERS report online
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2021-11-14
Dose 3 — Moderna
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2021-11-15
Survey response — days 1–6 daily, dose 3MedDRA: Arthralgia, Hypersensitivity, Hypoaesthesia oral, Palatal swelling — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Very painful right wrist joint through the back of my hand. Had mild allergic reaction with upper lip numbness and swelling of roof of my mouth Had taken Benadryl before vaccinationMedDRA releases: 2024-11 · check-in free text available
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2021-11-16
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fever · Joint pains, Fatigue or tirednessAdult check-in
- 2021-11-17
- 2021-11-18
- 2021-11-19
- 2021-11-20
- 2021-11-21
- 2021-11-28
- 2021-12-05
- 2021-12-12
- 2021-12-19
- 2021-12-26
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2022-02-13
Survey response — 3 months, dose 3MedDRA: Eye infection, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Diagnosed with eye infection Nov 27th Now Feb 13 and still trying to get rid of it completely · Healthcare visit (other): OphthalmologistMedDRA releases: 2024-11 · check-in free text available
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2022-02-13
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-02-18
Call successfulParticipant prefers to complete VAERS report online
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2022-08-01
Dose 4 — Moderna
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2022-08-02
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-08-03
- 2022-08-04
- 2022-08-05
- 2022-08-06
- 2022-08-07
- 2022-08-08
- 2022-08-15
- 2022-08-22
- 2022-08-29
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2022-09-05
Survey response — day 35, dose 4MedDRA: Glaucoma — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Diagnosed with GlaucomaMedDRA releases: 2024-11 · check-in free text available
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2022-09-05
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-09-07
Call successfulParticipant prefers to complete VAERS report online
- 2022-09-14
- 2022-10-31
-
2022-11-15
Dose 5 — ModernaCo-administered: Flu
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2022-11-16
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Swelling · Fever · Fatigue or tirednessAdult check-in
- 2022-11-17
- 2022-11-18
- 2022-11-19
- 2022-11-20
- 2022-11-21
- 2022-11-24
- 2022-11-29
- 2022-12-06
- 2022-12-13
- 2022-12-20
- 2022-12-28
- 2023-02-14
- 2023-05-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-08 | Moderna | |
| 3 | 2021-11-14 | Moderna | No |
| 4 | 2022-08-01 | Moderna | No |
| 5 | 2022-11-15 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-07 | Successful 2021-10-12 |
Participant prefers to complete VAERS report online |
| 2022-02-13 | Successful 2022-02-18 |
Participant prefers to complete VAERS report online |
| 2022-09-05 | Successful 2022-09-07 |
Participant prefers to complete VAERS report online |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Numb lips. Tingle on tip of my tongue, slight throat swelling
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Still treating yesterdays's mild anaphylactic reaction
Release 5 — day 7, dose 1
Systemic reaction (other): Arm i got shot in feels warm or irritated when i rub it, noth yestetday and today
Release 7 — day 0, dose 2
Systemic reaction (other): Took Benadryl 20 min before shot. Still have some to tongue swelling
Release 7 — day 7, dose 2
Systemic reaction (other): On side I got vaccinated my shoulder and neck started feeling real warm when putting dishes in cupboard
Release 8 — day 35, dose 2
Symptoms: 20 min after some repetitive movement I felt inflammation in the same spot down my arm all the way across shoulder and up neck as when I got second shot. It hurt but not as bad as day I got shot. It was about 10 seconds long
Release 10 — 6 months, dose 2
Symptoms: Arthritis in thumb
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Very painful right wrist joint through the back of my hand. Had mild allergic reaction with upper lip numbness and swelling of roof of my mouth Had taken Benadryl before vaccination
Release 11 — 3 months, dose 3
Symptoms: Diagnosed with eye infection Nov 27th Now Feb 13 and still trying to get rid of it completely
Healthcare visit (other): Ophthalmologist
Release 12 — day 35, dose 4
Symptoms: Diagnosed with Glaucoma
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 | Arthritis | · | · | ✓ |
| SD | Eye infection | · | · | ✓ |
| SD | Glaucoma | · | · | ✓ |
| SD | Inflammation | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SRO | Anaphylactic reaction | ✓ | ✓ | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Hypersensitivity | · | · | ✓ |
| SRO | Hypoaesthesia oral | ✓ | ✓ | ✓ |
| SRO | Palatal swelling | · | · | ✓ |
| SRO | Paraesthesia oral | ✓ | ✓ | ✓ |
| SRO | Pharyngeal swelling | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Skin irritation | ✓ | ✓ | ✓ |
| SRO | Swollen tongue | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release