YXF-71974-27043
5 vaccinations
10 coded responses
56 check-ins
10 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 975 / OR
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Dose 1 — Moderna
-
2021-03-18
Registered in v-safe
-
2021-03-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body achesAdult check-in
- 2021-03-19
- 2021-03-20
- 2021-03-21
-
2021-03-22
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal discomfort, Dyspepsia, Heart rate irregular — Feeling: FairFree text: Indigestion; irregular heartbeat; pressure in stomach.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-23
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal distension — Feeling: Good · Fatigue or tirednessFree text: Some stomach fullnessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
-
2021-03-31
Survey response — day 14, dose 1MedDRA: Sinusitis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sinus infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
- 2021-04-14
-
2021-04-21
Survey response — day 35, dose 1MedDRA: Urinary tract infection — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: UTIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-21
Report sent to call center — day 35, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-23
Dose 2 — Moderna
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2021-04-28
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event, Urinary tract infection — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Systemic reaction (other): Diagnosed with UTI on 4/18/21. Finished 7 days antibiotic 4/25/21. Video appointment with doctor tomorrow morning. · Healthcare visit (other): Video conference tomorrow. Urgent care, then ER on 4/18/21.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-29
Survey response — days 1–6 daily, dose 2MedDRA: Urinary tract infection — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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: Being treated for UTIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-29
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-30
Survey response — day 7, dose 2MedDRA: Urinary tract infection — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: On antibiotic for UTIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-06-04
- 2021-07-23
-
2021-10-22
Survey response — 6 months, dose 2MedDRA: Urinary tract infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: UTIMedDRA releases: 2024-11 · check-in free text available
-
2021-10-22
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-10-25
-
2021-11-30
Dose 3 — Moderna
- 2021-12-02
- 2021-12-03
- 2021-12-04
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-01-04
- 2022-01-11
- 2022-03-01
- 2022-05-31
-
2022-06-03
Dose 4 — Moderna
- 2022-06-04
- 2022-06-05
- 2022-06-06
- 2022-06-07
- 2022-06-08
- 2022-06-09
- 2022-06-10
-
2022-06-17
Survey response — day 14, dose 4MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Acid refluxMedDRA releases: 2024-11 · check-in free text available
- 2022-06-24
- 2022-07-01
-
2022-07-08
Survey response — day 35, dose 4MedDRA: Ear pain, Eustachian tube dysfunction, Paranasal sinus discomfort, Rhinorrhoea — Feeling: FairFree text: Sinus pressure, runny nose, right eustation tube area sore and intermittent earache, but ok today,MedDRA releases: 2024-11 · check-in free text available
- 2022-07-15
- 2022-09-02
-
2022-10-28
Dose 5 — Moderna
- 2022-11-02
- 2022-11-03
- 2022-11-04
- 2022-11-11
- 2022-11-18
- 2022-11-25
- 2022-12-02
- 2022-12-09
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-23 | Moderna | |
| 3 | 2021-11-30 | Moderna | No |
| 4 | 2022-06-03 | Moderna | No |
| 5 | 2022-10-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-21 | Unsuccessful | |
| 2021-04-28 | Unsuccessful | |
| 2021-04-29 | Unsuccessful | |
| 2021-10-22 | Unsuccessful |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Indigestion; irregular heartbeat; pressure in stomach.
Systemic reaction (other): Some stomach fullness
Release 6 — day 14, dose 1
Symptoms: Sinus infection
Release 7 — day 35, dose 1
Symptoms: UTI
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Diagnosed with UTI on 4/18/21. Finished 7 days antibiotic 4/25/21. Video appointment with doctor tomorrow morning.
Healthcare visit (other): Video conference tomorrow. Urgent care, then ER on 4/18/21.
Systemic reaction (other): Being treated for UTI
Release 8 — day 7, dose 2
Systemic reaction (other): On antibiotic for UTI
Release 10 — 6 months, dose 2
Symptoms: UTI
Release 12 — day 14, dose 4
Symptoms: Acid reflux
Release 12 — day 35, dose 4
Symptoms: Sinus pressure, runny nose, right eustation tube area sore and intermittent earache, but ok today,
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 | Ear pain | · | · | ✓ |
| SD | Eustachian tube dysfunction | · | · | ✓ |
| SD | Gastrooesophageal reflux disease | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SD | Urinary tract infection | ✓ | ✓ | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Abdominal distension | ✓ | ✓ | ✓ |
| SRO | Dyspepsia | ✓ | ✓ | ✓ |
| SRO | Heart rate irregular | ✓ | ✓ | ✓ |
| SRO | Urinary tract infection | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release