YZS-12825-42441
6 vaccinations
15 coded responses
77 check-ins
13 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 974 / OR
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
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2021-01-23
Dose 1 — Moderna
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
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2021-02-06
Survey response — day 14, dose 1MedDRA: Pruritus, Rash, Rash erythematous — Feeling: GoodFree text: On the 7th-8th day after the Moderna shot, I developed a red rash on my upper left arm. It was painless & vaguely itched. It looked exactly like so-called Covid Vaccine Arm as seen online. It has resolved now w/only slight pinkness remaining.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-20
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2021-02-28
Dose 2 — Moderna
- 2021-02-28
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2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache · Be unable to do your normal daily activitiesAdult check-in
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2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Yesterday I should have reported feeling Poor.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Epistaxis, Sinus headache — Feeling: Good · Site: PainFree text: Sinus headache day after shot. Next day, slight bilateral nose bleeding which continue a bit. NEVER had these issues before. Related to the shot?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-03-05
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2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-03-07
- 2021-03-14
- 2021-03-21
- 2021-03-28
- 2021-04-04
- 2021-04-11
- 2021-05-30
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2021-08-29
Survey response — 6 months, dose 2MedDRA: Adverse reaction, Respiratory tract congestion, Rhinorrhoea, Throat irritation — Feeling: FairFree text: Lately I am experiencing what I assume to be allergy symptoms. Some congestion and runny nose. Throat irritation. No coughing or fever.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-10-27
Dose 3 — Moderna
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2021-10-27
Survey response — day 0, dose 3MedDRA: Unevaluable event — Feeling: Good · Site: PainFree text: I just got the shot an hour agoMedDRA releases: 2024-11 · check-in free text available
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2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Presyncope — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Faint. Almost passed out trying to get myself water upstairsMedDRA releases: 2024-11 · check-in free text available
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2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fever · Headache, Fatigue or tiredness, Vomiting · Be unable to do your normal daily activitiesAdult check-in
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2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Night sweats — Feeling: GoodFree text: Night sweat (1)MedDRA releases: 2024-11 · check-in free text available
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2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Night sweats — Feeling: Good · Joint painsFree text: 2nd night in a row: Night SweatsMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
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2021-12-08
Survey response — day 42, dose 3MedDRA: Office visit, Wrist fracture — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Broken wrist (traumatic). No link to Covid vaccine · Healthcare visit (other): Day surgery centerMedDRA releases: 2024-11 · check-in free text available
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2021-12-08
Report sent to call center — day 42, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-10
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2021-12-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-26
- 2022-04-29
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2022-04-30
Dose 4 — Moderna
- 2022-04-30
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2022-05-01
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-05-02
Survey response — days 1–6 daily, dose 4MedDRA: Feeling abnormal — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Correcting yesterday, I felt "Poor"MedDRA releases: 2024-11 · check-in free text available
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-05-28
- 2022-06-04
- 2022-06-11
- 2022-07-30
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2022-09-25
Dose 5 — Moderna
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2022-09-25
Survey response — day 0, dose 5MedDRA: No adverse event — Feeling: GoodFree text: My shot was 3 hrs ago. Nothing so far.MedDRA releases: 2024-11 · check-in free text available
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2022-09-26
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2022-09-27
Survey response — days 1–6 daily, dose 5MedDRA: Night sweats — Feeling: Good · Fever · Chills, Fatigue or tiredness, NauseaFree text: Night sweatMedDRA releases: 2024-11 · check-in free text available
- 2022-09-28
- 2022-09-29
- 2022-09-30
- 2022-10-01
- 2022-10-02
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2022-10-09
Survey response — day 14, dose 5MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: GoodFree text: Today, a slight runny nose and slight sore throat. No fever. Rapid test results are negative. Exposure to nonsymptomatic person last Monday; we were outside and I was masked.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-16
- 2022-10-23
- 2022-10-30
- 2022-11-06
- 2022-12-25
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2023-03-26
Survey response — 6 months, dose 5MedDRA: Autoimmune disorder, Skin disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-03-26
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-03-28
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2023-04-28
Dose 6 — Moderna
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2023-05-04
Survey response — days 1–6 daily, dose 6MedDRA: Chills, Fatigue, Pain, Pyrexia — Feeling: Good · Site: PainMedDRA releases: 2024-11
- 2023-05-05
- 2023-05-12
- 2023-05-19
- 2023-05-26
- 2023-06-02
- 2023-06-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-28 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-30 | Moderna | No |
| 5 | 2022-09-25 | Moderna | No |
| 6 | 2023-04-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-08 | Successful 2021-12-15 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2023-03-26 | Unsuccessful |
Free text
Release 3 — day 14, dose 1
Symptoms: On the 7th-8th day after the Moderna shot, I developed a red rash on my upper left arm. It was painless & vaguely itched. It looked exactly like so-called Covid Vaccine Arm as seen online. It has resolved now w/only slight pinkness remaining.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Yesterday I should have reported feeling Poor.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Sinus headache day after shot. Next day, slight bilateral nose bleeding which continue a bit. NEVER had these issues before. Related to the shot?
Release 9 — 6 months, dose 2
Symptoms: Lately I am experiencing what I assume to be allergy symptoms. Some congestion and runny nose. Throat irritation. No coughing or fever.
Release 10 — day 0, dose 3
Systemic reaction (other): I just got the shot an hour ago
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Faint. Almost passed out trying to get myself water upstairs
Systemic reaction (other): Night sweat (1)
Systemic reaction (other): 2nd night in a row: Night Sweats
Release 10 — day 42, dose 3
Symptoms: Broken wrist (traumatic). No link to Covid vaccine
Healthcare visit (other): Day surgery center
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Correcting yesterday, I felt "Poor"
Release 12 — day 0, dose 5
Systemic reaction (other): My shot was 3 hrs ago. Nothing so far.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Night sweat
Release 12 — day 14, dose 5
Symptoms: Today, a slight runny nose and slight sore throat. No fever. Rapid test results are negative. Exposure to nonsymptomatic person last Monday; we were outside and I was masked.
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 | Adverse reaction | ✓ | · | ✓ |
| SD | Autoimmune disorder | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SD | Rhinorrhoea | ✓ | · | ✓ |
| SD | Skin disorder | · | · | ✓ |
| SD | Throat irritation | ✓ | · | ✓ |
| SD | Wrist fracture | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Epistaxis | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | · | · | ✓ |
| SRO | Night sweats | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Presyncope | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Sinus headache | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release