223-16927-06129
2 vaccinations
6 coded responses
24 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 306 / GA
- Registered
- 2021-03-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-21
Registered in v-safe
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2021-03-21
Dose 1 — Moderna
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2021-03-21
Survey response — day 0, dose 1MedDRA: Dysgeusia, Headache, Immediate post-injection reaction — Feeling: Good · Muscle or body achesFree text: Metallic taste in mouth and streaking pain at the base of my skull shortly after vaccine but it went away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-22
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Muscle or body achesFree text: Moderate pain in the whole arm of the injection even when immobileMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
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2021-03-28
Survey response — day 7, dose 1MedDRA: Headache — Feeling: Fair · HeadacheFree text: Dont believe my headache is related. I started menstruating last night.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-11
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2021-04-18
Dose 2 — Moderna
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2021-04-19
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · HeadacheAdult check-in
- 2021-04-22
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2021-04-23
Health check-in — days 1–6 daily, dose 2Feeling: Good · Chills, Fatigue or tirednessAdult check-in
- 2021-04-24
- 2021-04-27
- 2021-05-02
- 2021-05-09
- 2021-05-16
- 2021-05-23
- 2021-05-30
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2021-07-18
Survey response — 3 months, dose 2MedDRA: Aphonia, Bronchitis, Dyspnoea, Emergency care, Office visit, Oropharyngeal pain, Pre-existing disease, Productive cough, Pyrexia — 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 consultation, Emergency room or emergency department visitFree text: Severe bronchitis lasting over a month with trouble breathing. Sore throat, wet cough, lost voice, fever. ER visit and doctor visit. Have had bronchitis before but never that severe or with trouble breathingMedDRA releases: 2024-11 · check-in free text available
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2021-07-18
Report sent to call center — 3 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 pr1 call case(s)
- 2021-07-26
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2021-10-17
Survey response — 6 months, dose 2MedDRA: Bronchitis, Dyspnoea, Emergency care, Office visit — Feeling: Fair · 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 consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: During summer diagnosed as bronchitis. I've had it several times before but never had to go to the ER. The diff this time was I couldn't breathe. 2 trips, multi doctors visits & a month of gasping. Finally resolved approx 2 months after diagnosis.MedDRA releases: 2024-11 · check-in free text available
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2021-10-17
Report sent to call center — 6 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 · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2021-10-20
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2021-12-03
Call successfulParticipant prefers to complete VAERS report online
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2022-04-18
Survey response — 12 months, dose 2MedDRA: Adverse reaction, Arthralgia, Impaired healing, Injection site reaction, Mobility decreased, Office visit, Pain, Pain in extremity, Sleep disorder — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: The injection site took 3 months to heal. I had excruciating pain in my arm and shoulder. It hurt both to move & when still. I couldn't sleep on that side or raise my arm. · Healthcare visit (other): Had my regular Dr look at itMedDRA releases: 2024-11 · check-in free text available
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2022-04-18
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2022-04-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-21 | Moderna | |
| 2 | 2021-04-18 | Moderna |
Call center
3 call center cases
2 successful · 1 unsuccessful
Free text
Release 6 — day 0, dose 1
Systemic reaction (other): Metallic taste in mouth and streaking pain at the base of my skull shortly after vaccine but it went away.
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Moderate pain in the whole arm of the injection even when immobile
Release 6 — day 7, dose 1
Systemic reaction (other): Dont believe my headache is related. I started menstruating last night.
Release 9 — 3 months, dose 2
Symptoms: Severe bronchitis lasting over a month with trouble breathing. Sore throat, wet cough, lost voice, fever. ER visit and doctor visit. Have had bronchitis before but never that severe or with trouble breathing
Release 10 — 6 months, dose 2
Symptoms: During summer diagnosed as bronchitis. I've had it several times before but never had to go to the ER. The diff this time was I couldn't breathe. 2 trips, multi doctors visits & a month of gasping. Finally resolved approx 2 months after diagnosis.
Release 11 — 12 months, dose 2
Symptoms: The injection site took 3 months to heal. I had excruciating pain in my arm and shoulder. It hurt both to move & when still. I couldn't sleep on that side or raise my arm.
Healthcare visit (other): Had my regular Dr look at it
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 | Adverse reaction | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Aphonia | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Impaired healing | · | · | ✓ |
| SD | Injection site reaction | · | · | ✓ |
| SD | Mobility decreased | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Sleep disorder | · | · | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release