YY9-23694-49265
3 vaccinations
5 coded responses
24 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 950 / CA
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-04
Registered in v-safe
-
2021-02-04
Dose 1 — Moderna
- 2021-02-04
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
- 2021-02-25
-
2021-03-04
Dose 2 — Moderna
- 2021-03-04
-
2021-03-05
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Feeling abnormal, Headache, Myalgia, Visual impairment — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Brain fog and Vision affects. Severe chills were last night, gone today. Severe Headache and moderate muscle aches started today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-06
Survey response — days 1–6 daily, dose 2MedDRA: Eye movement disorder, Feeling jittery — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tirednessFree text: Feeling moderately jittery in body and sight in morning . Mostly gone now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy, Oropharyngeal pain — Feeling: FairFree text: Mild sore throat and swollen glandMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-02
-
2021-04-08
Survey response — day 35, dose 2MedDRA: Headache, Nausea, Self-medication — Feeling: FairFree text: Moderate headaches and slight nausea, both of which are VERY rare for me, with no apparent reason or cause. Resolved with aspirinMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
-
2021-06-03
Survey response — 3 months, dose 2MedDRA: Neuralgia, Office visit, Toothache — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Intermittent brief periods of pain between my front teeth where I already have some fillings, but the dentist says there is nothing wrong with my teeth or gums, and that its likely nerve pain originating else. /Ive developed 1 or 2 planters w · Healthcare visit (other): Dentist checkup/DermatologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-03
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-02
-
2021-12-27
Dose 3 — Moderna
-
2022-01-31
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-04 | Moderna | |
| 3 | 2021-12-27 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-03 | Successful 2022-01-31 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Brain fog and Vision affects. Severe chills were last night, gone today. Severe Headache and moderate muscle aches started today.
Systemic reaction (other): Feeling moderately jittery in body and sight in morning . Mostly gone now.
Systemic reaction (other): Mild sore throat and swollen gland
Release 7 — day 35, dose 2
Symptoms: Moderate headaches and slight nausea, both of which are VERY rare for me, with no apparent reason or cause. Resolved with aspirin
Release 8 — 3 months, dose 2
Symptoms: Intermittent brief periods of pain between my front teeth where I already have some fillings, but the dentist says there is nothing wrong with my teeth or gums, and that its likely nerve pain originating else. /Ive developed 1 or 2 planters w
Healthcare visit (other): Dentist checkup/Dermatologist
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 | Headache | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Neuralgia | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Toothache | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Eye movement disorder | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Feeling jittery | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Visual impairment | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release