24B-30868-67403
2 vaccinations
4 coded responses
7 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 287 / NC
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-04
Dose 1 — Moderna
-
2021-02-05
Registered in v-safe
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2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Erythema, Immediate post-injection reaction — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Nausea · Be unable to workFree text: 20 m after the shot yesterday my face turned bright red. That lasted for about an hourMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to workAdult check-in
- 2021-02-07
-
2021-02-08
Survey response — days 1–6 daily, dose 1MedDRA: Gingival pain, Toothache — Feeling: GoodFree text: Maybe not related. But my mouth has been wired since yesterday midday. Sore on my gum. Raw, teeth sort of ache. And my husband who got the shot at the same time has some intestinal distress.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
-
2021-03-04
Dose 2 — Moderna
-
2021-09-03
Survey response — 6 months, dose 2MedDRA: Asthenia, Chills, Fatigue, Neovascular age-related macular degeneration, Office visit, 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 professionalFree text: Symptoms: Wet macular degeneration inset 2-3 days after 2nd shot. Fever of 102 first night after shot, then debilitating chills and fatigue for 2 days. Note that I am about 20 years younger than most WMD patients Tech at ophthalmologist Ofc noted a surge · Healthcare visit (other): Eye doctor then ophthalmologist- now having regular injections in eyeMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-03
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 pr1 call case(s)
- 2021-09-08
-
2022-03-06
Survey response — 12 months, dose 2MedDRA: COVID-19 — 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, Outpatient clinic or urgent care clinic visitFree text: CovidMedDRA releases: 2024-11 · check-in free text available
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2022-03-06
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-03-08
- 2022-03-10
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2022-03-11
Callback requested for10:15AM ET
-
2022-03-11
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-04 | Moderna |
Call center
2 call center cases
2 successful
VAERS report filed, before or during a call: 1
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): 20 m after the shot yesterday my face turned bright red. That lasted for about an hour
Systemic reaction (other): Maybe not related. But my mouth has been wired since yesterday midday. Sore on my gum. Raw, teeth sort of ache. And my husband who got the shot at the same time has some intestinal distress.
Release 9 — 6 months, dose 2
Symptoms: Wet macular degeneration inset 2-3 days after 2nd shot. Fever of 102 first night after shot, then debilitating chills and fatigue for 2 days. Note that I am about 20 years younger than most WMD patients Tech at ophthalmologist Ofc noted a surge
Healthcare visit (other): Eye doctor then ophthalmologist- now having regular injections in eye
Release 11 — 12 months, dose 2
Symptoms: Covid
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 | Asthenia | ✓ | · | ✓ |
| SD | Chills | ✓ | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Neovascular age-related macular degeneration | ✓ | · | ✓ |
| SD | Pyrexia | ✓ | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Gingival pain | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Toothache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release