22G-33752-30140
5 vaccinations
4 coded responses
31 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 379 / TN
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Dose 1 — Moderna
-
2021-03-05
Registered in v-safe
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
- 2021-03-25
-
2021-04-01
Dose 2 — Moderna
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-04-03
- 2021-04-04
- 2021-04-05
-
2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: Joint swelling — Feeling: GoodFree text: Experiencing swollen ankles first noticed on 4/3. I don't believe it is related to the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
-
2021-07-01
Survey response — 3 months, dose 2MedDRA: Condition aggravated, Office visit, Pre-existing disease, Taste disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Worsening shortness of breath. Under treatment for organizing pneumonia. since before vaccination. Medical tasting is continuing. · Healthcare visit (other): Doctor's office and clinical tests.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-01
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)
- 2021-07-13
-
2021-09-30
Survey response — 6 months, dose 2MedDRA: Condition aggravated, Dyspnoea, Office visit, Pneumonitis, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I have been diagnosed with myositis with interstitial lung disease. It predates my Covid vaccinations but symptoms of lung inflammation and shortness of breath have re-emerged and I am on heavy dose of prednisone. · Healthcare visit (other): Doctor's office.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-30
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-11-19
Call successfulParticipant prefers to complete VAERS report online
-
2021-12-02
Dose 3 — Moderna
-
2022-04-01
Survey response — 12 months, dose 2MedDRA: Office visit, Polymyositis, Respiratory disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I have been diagnosed with polymyositis with respiratory involvement. · Healthcare visit (other): In person doctor's apptMedDRA releases: 2024-11 · check-in free text available
-
2022-04-01
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-04-04
Call successfulParticipant prefers to complete VAERS report online
-
2022-04-27
Dose 4 — Moderna
-
2022-09-27
Dose 5 — Moderna
- 2022-10-05
- 2022-10-11
- 2022-10-20
- 2022-10-25
- 2022-11-01
- 2022-11-08
- 2022-12-27
- 2023-03-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-12-02 | Moderna | No |
| 4 | 2022-04-27 | Moderna | No |
| 5 | 2022-09-27 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Experiencing swollen ankles first noticed on 4/3. I don't believe it is related to the vaccine.
Release 9 — 3 months, dose 2
Symptoms: Worsening shortness of breath. Under treatment for organizing pneumonia. since before vaccination. Medical tasting is continuing.
Healthcare visit (other): Doctor's office and clinical tests.
Release 9 — 6 months, dose 2
Symptoms: I have been diagnosed with myositis with interstitial lung disease. It predates my Covid vaccinations but symptoms of lung inflammation and shortness of breath have re-emerged and I am on heavy dose of prednisone.
Healthcare visit (other): Doctor's office.
Release 11 — 12 months, dose 2
Symptoms: I have been diagnosed with polymyositis with respiratory involvement.
Healthcare visit (other): In person doctor's appt
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 | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Pneumonitis | · | · | ✓ |
| SD | Polymyositis | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Taste disorder | ✓ | ✓ | ✓ |
| SRO | Joint swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release