Z89-51140-86244
5 vaccinations
7 coded responses
53 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 208 / MD
- Registered
- 2021-03-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-23
Dose 1 — Moderna
-
2021-03-24
Registered in v-safe
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
-
2021-03-28
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue, Seasonal allergy — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Fatigue may be due to seasonal allergies. Pollen count has been moderately high to high over the past 24 hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-29
- 2021-03-30
- 2021-04-06
- 2021-04-13
-
2021-04-20
Dose 2 — Moderna
-
2021-04-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · HeadacheFree text: May be due to seasonal allergiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-04-27
-
2021-05-04
Survey response — day 14, dose 2MedDRA: Cough, Hypersensitivity, Oral pain, Oropharyngeal pain — Feeling: FairFree text: I developed a sore throat on Saturday evening (5/1/2021). It started on the hard palate at the very back of my mouth. When coughing I aggravated the uvula, so it is also sore. I think it is allergy-related, since I have no other symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-07-20
- 2021-10-19
-
2021-10-29
Dose 3 — Moderna
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
-
2021-11-12
Survey response — day 14, dose 3MedDRA: Facial paralysis, Office visit, Sinus headache, Swelling face — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professionalFree text: Symptoms: Sinus headache. Swollen forehead. Droopy eyelid. · Healthcare visit (other): Office visit with my primary care physician. Sinus x-rays at radiology center.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-12
Report sent to call center — day 14, dose 3Be unable to work or attend school · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-16
- 2021-11-19
-
2021-11-19
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-26
- 2021-12-03
- 2021-12-10
-
2022-01-28
Survey response — 3 months, dose 3MedDRA: Pharyngeal swelling, Swollen tongue — Feeling: FairFree text: Tongue and throat swelling, but I don't think it's related to the vaccine.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-29
-
2022-05-05
Dose 4 — Moderna
- 2022-05-10
- 2022-05-11
- 2022-05-12
- 2022-05-19
-
2022-05-26
Survey response — day 21, dose 4MedDRA: Fatigue, Pain, Throat irritation, Upper-airway cough syndrome — Feeling: GoodFree text: Mild irritated throat. Increase in post-nasal drip. Fatigue. Some achiness. Feels like I'm fighting a bug. May have been exposed to COVID-19 on May 22, 2022.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-02
- 2022-06-09
- 2022-06-16
- 2022-08-04
-
2022-10-20
Dose 5 — ModernaCo-administered: Flu
-
2022-11-05
Survey response — day 14, dose 5MedDRA: Blood triglycerides increased, Glucose tolerance impaired, Low density lipoprotein decreased, Low density lipoprotein increased, 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: On September 5, 2022, I tested positive for COVID-19. October 14, 2022, blood work showed high triglycerides, high LDL, low LDL, and prediabetic blood sugar levels. I'm adjusting my lifestyle habits.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-05
Report sent to call center — day 14, dose 5Be 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)
- 2022-11-07
- 2022-11-10
-
2022-11-10
Call successfulNot applicable - Accidental Reporting
- 2022-11-17
- 2022-11-24
- 2022-12-01
- 2023-01-19
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-23 | Moderna | |
| 2 | 2021-04-20 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-05-05 | Moderna | No |
| 5 | 2022-10-20 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-12 | Successful 2021-11-19 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-11-05 | Successful 2022-11-10 |
Not applicable - Accidental Reporting |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Fatigue may be due to seasonal allergies. Pollen count has been moderately high to high over the past 24 hours.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): May be due to seasonal allergies
Release 8 — day 14, dose 2
Symptoms: I developed a sore throat on Saturday evening (5/1/2021). It started on the hard palate at the very back of my mouth. When coughing I aggravated the uvula, so it is also sore. I think it is allergy-related, since I have no other symptoms.
Release 10 — day 14, dose 3
Symptoms: Sinus headache. Swollen forehead. Droopy eyelid.
Healthcare visit (other): Office visit with my primary care physician. Sinus x-rays at radiology center.
Release 11 — 3 months, dose 3
Symptoms: Tongue and throat swelling, but I don't think it's related to the vaccine.
Release 11 — day 21, dose 4
Symptoms: Mild irritated throat. Increase in post-nasal drip. Fatigue. Some achiness. Feels like I'm fighting a bug. May have been exposed to COVID-19 on May 22, 2022.
Release 12 — day 14, dose 5
Symptoms: On September 5, 2022, I tested positive for COVID-19. October 14, 2022, blood work showed high triglycerides, high LDL, low LDL, and prediabetic blood sugar levels. I'm adjusting my lifestyle habits.
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 | Blood triglycerides increased | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Facial paralysis | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Glucose tolerance impaired | · | · | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Low density lipoprotein decreased | · | · | ✓ |
| SD | Low density lipoprotein increased | · | · | ✓ |
| SD | Oral pain | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pharyngeal swelling | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinus headache | · | · | ✓ |
| SD | Swelling face | · | · | ✓ |
| SD | Swollen tongue | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Seasonal allergy | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release