YZQ-12217-72194
4 vaccinations
6 coded responses
37 check-ins
6 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 190 / PA
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-13
Registered in v-safe
-
2021-01-13
Dose 1 — Moderna
- 2021-01-13
-
2021-01-14
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-22
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Moderna
- 2021-02-10
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2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Fatigue or tirednessAdult check-in
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Chills, Headache, Muscle or body achesAdult check-in
- 2021-02-15
-
2021-02-16
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: Good · Fatigue or tirednessFree text: Very mild fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-03-03
- 2021-03-10
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2021-03-19
Survey response — day 35, dose 2MedDRA: Respiratory tract congestion, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I have a sinus infection & congestion.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-24
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2021-05-12
Survey response — 3 months, dose 2MedDRA: Office visit, Superficial vein thrombosis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Superficial Thrombophlebitis · Healthcare visit (other): Primary dr & vascular surgeonMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-12
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-11
-
2021-10-27
Dose 3 — Moderna
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2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Fatigue or tiredness, NauseaAdult check-in
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Fatigue or tirednessAdult check-in
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2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body achesAdult check-in
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2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Discomfort, Superficial vein thrombosis — Feeling: Fair · Site: Redness, Swelling, Itching · Chills, Fatigue or tirednessFree text: Two months after 2nd Moderna shot I had a superficial thrombosis in my leg which subsided in a couple months & this week developed some of initial discomfort. Windering if this may be related to vaccines will ask my Dr.MedDRA releases: 2024-11 · check-in free text available
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2021-11-05
Survey response — day 7, dose 3MedDRA: Discomfort — Feeling: Good · Site: Itching · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Some discomfort in veins in my legsMedDRA releases: 2024-11 · check-in free text available
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2021-11-05
Report sent to call center — day 7, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-11-08
- 2021-11-14
- 2021-11-19
- 2021-12-01
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2021-12-09
Survey response — day 42, dose 3MedDRA: Medical counselling, Self-medication, Varicose vein — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Not worsened but I do have some lingering effects my doctor thinks it may be the antibodies may have caused some inflammation & it's effecting my varicose veins. I'm taking a full aspirin rather than a baby aspirin for now. · Healthcare visit (other): Just a call to my doctorMedDRA releases: 2024-11 · check-in free text available
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2021-12-09
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-12-10
- 2022-01-26
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2022-04-03
Dose 4 — Moderna
- 2022-04-24
- 2022-05-17
- 2022-10-03
- 2023-04-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-19 | Unsuccessful | |
| 2021-05-12 | Unsuccessful | |
| 2021-11-05 | Unsuccessful | |
| 2021-12-09 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Very mild fatigue
Release 5 — day 35, dose 2
Symptoms: I have a sinus infection & congestion.
Release 8 — 3 months, dose 2
Symptoms: Superficial Thrombophlebitis
Healthcare visit (other): Primary dr & vascular surgeon
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Two months after 2nd Moderna shot I had a superficial thrombosis in my leg which subsided in a couple months & this week developed some of initial discomfort. Windering if this may be related to vaccines will ask my Dr.
Release 10 — day 7, dose 3
Systemic reaction (other): Some discomfort in veins in my legs
Release 10 — day 42, dose 3
Symptoms: Not worsened but I do have some lingering effects my doctor thinks it may be the antibodies may have caused some inflammation & it's effecting my varicose veins. I'm taking a full aspirin rather than a baby aspirin for now.
Healthcare visit (other): Just a call to my doctor
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 | Medical counselling | · | · | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SD | Superficial vein thrombosis | ✓ | ✓ | ✓ |
| SD | Varicose vein | · | · | ✓ |
| SRO | Discomfort | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Superficial vein thrombosis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release