YVS-30889-79462
4 vaccinations
2 coded responses
46 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 112 / NY
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-18
Registered in v-safe
-
2021-01-18
Dose 1 — Moderna
- 2021-01-18
-
2021-01-19
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-02-01
- 2021-02-08
- 2021-02-15
-
2021-02-16
Dose 2 — Moderna
- 2021-02-16
-
2021-02-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tirednessAdult check-in
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-17
-
2021-10-29
Dose 3 — Moderna
-
2021-10-29
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
-
2021-12-12
Survey response — day 42, dose 3MedDRA: Injection site swelling — Feeling: GoodFree text: I have an egg-shaped, skin colored bump on the arm where I was injected. However, 3 weeks after I received the booster, I had my third Gardasil-9 shot, and this might have caused the bump, although I'm not totally sure.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-30
Survey response — 3 months, dose 3MedDRA: Injection site cyst, Injection site swelling — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Cyst on arm where I received the vaccine and booster. I also received a flu shot and 3 Gardasil 9 shots on the same arm within a 9-month period. I suspect the cyst started forming after the booster as I noticed swelling and a raised bump.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-30
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-21
Call successfulCompleted over the phone
- 2022-04-29
-
2022-09-21
Dose 4 — Moderna
- 2022-09-30
- 2022-10-05
- 2022-10-13
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-12-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-18 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-09-21 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-30 | Successful 2022-04-21 |
Completed over the phone |
Free text
Release 10 — day 42, dose 3
Symptoms: I have an egg-shaped, skin colored bump on the arm where I was injected. However, 3 weeks after I received the booster, I had my third Gardasil-9 shot, and this might have caused the bump, although I'm not totally sure.
Release 11 — 3 months, dose 3
Symptoms: Cyst on arm where I received the vaccine and booster. I also received a flu shot and 3 Gardasil 9 shots on the same arm within a 9-month period. I suspect the cyst started forming after the booster as I noticed swelling and a raised bump.
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 | Injection site cyst | · | · | ✓ |
| SD | Injection site swelling | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release