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YYC-18843-51892

4 vaccinations 11 coded responses 38 check-ins 10 free-text entries 3 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
338 / FL
Registered
2021-03-04
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-03
    Dose 1 — Moderna
  2. 2021-03-04
    Registered in v-safe
  3. 2021-03-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Adverse reaction — Feeling: Good
    Free text: Mild symptoms
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-03-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-03-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-10
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-17
    Survey response — day 14, dose 1
    MedDRA: Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Allergies kicked up my sinuses big time due to heavy pollen count. Head congestion and coughing. To Urgent Care this morning. Told the doctor I had to be better so I could get my second shot on 3/31. He gave me a steroid shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-17
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  12. 2021-03-24
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-03-31
    Dose 2 — Moderna
  14. 2021-03-31
    Survey response — day 0, dose 2
    MedDRA: Unevaluable event — Feeling: Good
    Free text: Just got 2nd shot 15 minutes ago.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: No adverse event — Feeling: Good · Site: Pain, Redness, Swelling
    Free text: No not at this time.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Muscle spasms — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness
    Free text: Leg and ankle cramping
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Muscle spasms — Feeling: Good · Site: Redness, Swelling, Itching
    Free text: Leg and ankle cramps
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Arthralgia, Muscle spasms, Pain in extremity — Feeling: Good · Site: Redness, Swelling
    Free text: Cramps in ankle and leg
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-04-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness · None
    Adult check-in
  20. 2021-04-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness · None
    Adult check-in
  21. 2021-04-07
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Redness · None
    Adult check-in
  22. 2021-04-14
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-21
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-28
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-05
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-12
    Survey response — day 42, dose 2
    MedDRA: Breast mass, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Found possible lump in right breast. Mammo and ultrasound June 2nd. · Healthcare visit (other): GYN office appt with MD.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-05-12
    Report sent to call center — day 42, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  28. 2021-06-30
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-09-29
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  30. 2021-12-03
    Dose 3 — Moderna
  31. 2021-12-17
    Call successful
    Not applicable - Accidental Reporting
  32. 2021-12-17
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  33. 2022-04-04
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  34. 2022-11-18
    Dose 4 — Moderna
  35. 2022-11-19
    Survey response — days 1–6 daily, dose 4
    MedDRA: Neck pain — Feeling: Poor · Site: Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Neck ache
    MedDRA releases: 2024-11 · check-in free text available
  36. 2022-11-20
    Survey response — days 1–6 daily, dose 4
    MedDRA: Mobility decreased, Pain in extremity — Feeling: Good · Site: Redness, Swelling
    Free text: Arm sore. Can't reach arm up even with shoulder
    MedDRA releases: 2024-11 · check-in free text available
  37. 2022-11-21
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Redness, Swelling · None
    Adult check-in
  38. 2022-11-22
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Redness · None
    Adult check-in
  39. 2022-11-23
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Redness · None
    Adult check-in
  40. 2022-11-25
    Health check-in — day 7, dose 4
    Feeling: Good · Site: Redness · None
    Adult check-in
  41. 2022-12-02
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  42. 2022-12-09
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  43. 2022-12-16
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  44. 2022-12-23
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  45. 2022-12-30
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  46. 2023-02-17
    Survey response — 3 months, dose 4
    MedDRA: Immune system disorder, Lichen sclerosus, Skin disorder — Feeling: Good · Get care from a doctor or other healthcare professional
    MedDRA releases: 2024-11
  47. 2023-02-17
    Report sent to call center — 3 months, dose 4
    Get care from a doctor or other healthcare professional
    1 call case(s)
  48. 2023-02-20
    Call successful
    Does not wish to fill out VAERS report
  49. 2023-05-19
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-03Moderna
22021-03-31Moderna
32021-12-03Moderna No
42022-11-18Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-03-17 Successful
2021-12-17
 Not applicable - Accidental Reporting
2021-05-12 Successful
2021-12-17
 Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2023-02-17 Successful
2023-02-20
 Does not wish to fill out VAERS report

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Mild symptoms

Release 5 — day 14, dose 1

2021-03-17

Symptoms: Allergies kicked up my sinuses big time due to heavy pollen count. Head congestion and coughing. To Urgent Care this morning. Told the doctor I had to be better so I could get my second shot on 3/31. He gave me a steroid shot.

Release 6 — day 0, dose 2

2021-03-31

Systemic reaction (other): Just got 2nd shot 15 minutes ago.

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): No not at this time.

2021-04-02

Systemic reaction (other): Leg and ankle cramping

2021-04-03

Systemic reaction (other): Leg and ankle cramps

2021-04-04

Systemic reaction (other): Cramps in ankle and leg

Release 8 — day 42, dose 2

2021-05-12

Symptoms: Found possible lump in right breast. Mammo and ultrasound June 2nd.
Healthcare visit (other): GYN office appt with MD.

Release 12 — days 1–6 daily, dose 4

2022-11-19

Systemic reaction (other): Neck ache

2022-11-20

Systemic reaction (other): Arm sore. Can't reach arm up even with shoulder

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

FieldPreferred term2021-092023-042024-11
HCVOImmune system disorder · · ✓
HCVOOffice visit ✓ ✓ ✓
HCVOSkin disorder · · ✓
SDBreast mass ✓ ✓ ✓
SDLichen sclerosus · · ✓
SDPre-existing disease ✓ ✓ ✓
SROAdverse reaction ✓ ✓ ✓
SROArthralgia ✓ ✓ ○
SROMobility decreased · · ✓
SROMuscle spasms ✓ ✓ ✓
SRONeck pain · · ✓
SRONo adverse event ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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