YWL-30250-77802
5 vaccinations
6 coded responses
66 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 373 / TN
- Registered
- 2021-03-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Registered in v-safe
-
2021-03-03
Dose 1 — Moderna
- 2021-03-03
- 2021-03-04
- 2021-03-05
-
2021-03-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
-
2021-03-17
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: GoodFree text: Some mild itching and redness, swelling at injection site day 8 - present. Worse on days 8-12 but subsiding. Mild-No treatment necessaryMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
-
2021-03-31
Dose 2 — Moderna
-
2021-03-31
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
-
2021-04-14
Survey response — day 14, dose 2MedDRA: Herpes simplex, Vaccine positive rechallenge — Feeling: GoodFree text: Herpes outbreak 7-8 days after each vaccine. (I get an outbreak following every viral illness, but I havent been sick.Didnt know if it was related the first time but now with it occurring again, thought I should report.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
- 2021-04-28
-
2021-05-05
Survey response — day 35, dose 2MedDRA: Self-medication, Urticaria — Feeling: FairFree text: Hives over most of my body excluding face, onset May 1. Never experienced before. Worse at night. No other S/S No changes or exposures to explain. Treating myself with Benadryl for night itching prn. Hopefully self resolving, may see dr if notMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-12
- 2021-06-30
- 2021-09-29
-
2021-10-28
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-30
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Itching · DiarrheaAdult check-in
-
2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-11-02
- 2021-11-04
-
2021-11-13
Survey response — day 14, dose 3MedDRA: Herpes simplex, Pre-existing disease, Reaction to previous exposure to any vaccine, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Herpes simplex outbreak (had one after each Covid vaccine including the recent booster ) · Healthcare visit (other): Rx valcyclovirMedDRA releases: 2024-11 · check-in free text available
-
2021-11-13
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2021-11-16
Call successfulParticipant prefers to complete VAERS report online
- 2021-11-18
- 2021-11-26
- 2021-12-02
- 2021-12-09
- 2022-01-27
- 2022-04-28
-
2022-06-17
Dose 4 — Moderna
-
2022-06-17
Health check-in — day 0, dose 4Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-06-18
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2022-06-19
- 2022-06-20
- 2022-06-21
- 2022-06-22
- 2022-06-23
- 2022-06-24
- 2022-07-01
- 2022-07-08
- 2022-07-15
- 2022-07-22
- 2022-07-29
- 2022-09-16
-
2022-10-15
Dose 5 — Moderna
-
2022-10-17
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-10-18
Survey response — days 1–6 daily, dose 5MedDRA: Chills, Fatigue, Pyrexia — Feeling: GoodFree text: Had fever and chills first night -1 1/2 days of fatigue-good nowMedDRA releases: 2024-11 · check-in free text available
- 2022-10-19
- 2022-10-20
- 2022-10-21
- 2022-10-22
- 2022-10-29
- 2022-11-05
- 2022-11-12
- 2022-11-19
- 2022-11-27
- 2023-01-14
-
2023-04-17
Survey response — 6 months, dose 5MedDRA: Fatigue, Pain, Pyrexia, Upper respiratory tract congestion — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-31 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-06-17 | Moderna | No |
| 5 | 2022-10-15 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-13 | Successful 2021-11-16 |
Participant prefers to complete VAERS report online |
Free text
Release 5 — day 14, dose 1
Symptoms: Some mild itching and redness, swelling at injection site day 8 - present. Worse on days 8-12 but subsiding. Mild-No treatment necessary
Release 7 — day 14, dose 2
Symptoms: Herpes outbreak 7-8 days after each vaccine. (I get an outbreak following every viral illness, but I havent been sick.Didnt know if it was related the first time but now with it occurring again, thought I should report.
Release 8 — day 35, dose 2
Symptoms: Hives over most of my body excluding face, onset May 1. Never experienced before. Worse at night. No other S/S No changes or exposures to explain. Treating myself with Benadryl for night itching prn. Hopefully self resolving, may see dr if not
Release 10 — day 14, dose 3
Symptoms: Herpes simplex outbreak (had one after each Covid vaccine including the recent booster )
Healthcare visit (other): Rx valcyclovir
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Had fever and chills first night -1 1/2 days of fatigue-good now
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 | Unevaluable event | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Herpes simplex | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Upper respiratory tract congestion | · | · | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SD | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release