Z3Y-94952-72451
4 vaccinations
7 coded responses
34 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 031 / NH
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-11
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessFree text: Slight headache that left as soon as I acknowledged it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-27
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Headache, Injection site erythema, Injection site warmth — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body achesFree text: Redness below shot area, warm to the touch x2 days, swelling less today. Some a Chinese and mild headache if I exert myself.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
-
2021-02-01
Survey response — day 7, dose 2MedDRA: Headache — Feeling: Good · HeadacheFree text: I woke up with a headache but now its resolved.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-08
Survey response — day 14, dose 2MedDRA: Fatigue, SARS-CoV-2 test negative — Feeling: GoodFree text: On two afternoons I felt yucky tired, but I just pushed through.I had a COVID test last Thursday that was negative for COVID-19.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-15
Survey response — day 21, dose 2MedDRA: Ear pain, Initial insomnia, Neck pain, Pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: Last night I experienced pain in my neck gland that radiated up to my ear that made it difficult to fall asleep. Its gone today and I was able to eventually fall asleep. Not sure if its related to the vaccine, but you asked.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-24
- 2021-03-01
- 2021-03-09
- 2021-04-26
- 2021-07-26
-
2022-01-25
Survey response — 12 months, dose 2MedDRA: Brain fog, COVID-19, Cough, Emotional disorder, Fatigue, Immunoglobulin therapy, Influenza like illness, Influenza virus test negative, Office visit, Pain, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: I had COVID 2x. In October '21 where I had mostly fatigue (physical and emotional) & some aches & brain fog. And again in January '22 where I had flu like respiratory symptoms & now a lingering cough. · Healthcare visit (other): 1st time I had monoclonal antibody treatment. 2nd time my doctor brought me in for an office visit and to test me for COVID, flu and RSV. I was positive for COVID. Negative for the other tests.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-25
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-01-27
-
2022-04-23
Dose 3 — Moderna
- 2022-07-25
-
2022-09-08
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-23
- 2022-09-29
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-12-08
-
2023-03-09
Survey response — 6 months, dose 4MedDRA: Dyspnoea exertional, Hypersensitivity, Office visit, Pre-existing disease, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
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2023-03-09
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2023-03-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-03-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna | |
| 3 | 2022-04-23 | Moderna | No |
| 4 | 2022-09-08 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-25 | Successful 2023-03-10 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-03-09 | Successful 2023-03-10 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Slight headache that left as soon as I acknowledged it.
Systemic reaction (other): Redness below shot area, warm to the touch x2 days, swelling less today. Some a Chinese and mild headache if I exert myself.
Release 3 — day 7, dose 2
Systemic reaction (other): I woke up with a headache but now its resolved.
Release 3 — day 14, dose 2
Symptoms: On two afternoons I felt yucky tired, but I just pushed through.I had a COVID test last Thursday that was negative for COVID-19.
Release 4 — day 21, dose 2
Symptoms: Last night I experienced pain in my neck gland that radiated up to my ear that made it difficult to fall asleep. Its gone today and I was able to eventually fall asleep. Not sure if its related to the vaccine, but you asked.
Release 11 — 12 months, dose 2
Symptoms: I had COVID 2x. In October '21 where I had mostly fatigue (physical and emotional) & some aches & brain fog. And again in January '22 where I had flu like respiratory symptoms & now a lingering cough.
Healthcare visit (other): 1st time I had monoclonal antibody treatment. 2nd time my doctor brought me in for an office visit and to test me for COVID, flu and RSV. I was positive for COVID. Negative for the other tests.
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 | Immunoglobulin therapy | · | · | ✓ |
| HCVO | Influenza virus test negative | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea exertional | · | · | ✓ |
| SD | Ear pain | ✓ | ✓ | ✓ |
| SD | Emotional disorder | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Initial insomnia | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Self-medication | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release