2AQ-12525-66469
5 vaccinations
12 coded responses
51 check-ins
12 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 780 / TX
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
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2021-02-03
Dose 1 — Moderna
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2021-02-03
Survey response — day 0, dose 1MedDRA: Myalgia, Pain, Pain in extremity — Feeling: Good · Site: PainFree text: Arm muscle is sore to movementMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Myalgia — Feeling: Fair · Site: Pain · HeadacheFree text: Muscle ache in armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: Pain · Headache, Fatigue or tirednessFree text: Pain in arm at injection site much lessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Arm is a little tender at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
- 2021-02-08
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2021-02-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-02-10
Survey response — day 7, dose 1MedDRA: Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: UTIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-10
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-17
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2021-02-24
Survey response — day 21, dose 1MedDRA: Rash — Feeling: GoodFree text: Rash on tops of both breasts and abdomenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Dose 2 — Moderna
- 2021-03-03
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2021-03-04
Survey response — days 1–6 daily, dose 2MedDRA: Burning sensation, Chest pain — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Burning sensation in upper chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Survey response — days 1–6 daily, dose 2MedDRA: Muscle spasms — Feeling: Good · Site: Pain · HeadacheFree text: Muscle spasm in right shoulderMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-07
- 2021-03-08
- 2021-03-09
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2021-03-10
Survey response — day 7, dose 2MedDRA: Chest pain — Feeling: FairFree text: Chest painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Survey response — day 14, dose 2MedDRA: Chest pain, Gastrooesophageal reflux disease, Oesophagitis, Pre-existing disease — Feeling: GoodFree text: Chest pain/burning in chest, esophagitis, GERDMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-06-02
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2021-07-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2021-09-01
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2021-10-15
Dose 3 — Moderna
- 2021-10-27
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-21
- 2021-11-28
- 2022-01-14
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2022-04-12
Dose 4 — Moderna
- 2022-04-15
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-26
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2022-05-03
Survey response — day 21, dose 4MedDRA: Vitreous detachment — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Vitreal separation in left eyeMedDRA releases: 2024-11 · check-in free text available
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2022-05-03
Report sent to call center — day 21, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-05-04
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-10
- 2022-05-17
- 2022-05-24
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2022-07-12
Survey response — 3 months, dose 4MedDRA: COVID-19, Cough, Headache, Oropharyngeal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Covid positive on 6/29/22. Took Paxlovid. Rebound positive 7/12/22. Sore throat and cough both times plus headache.MedDRA releases: 2024-11 · check-in free text available
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2022-07-12
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-07-13
Call successfulParticipant prefers to complete VAERS report online
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2022-10-13
Dose 5 — Pfizer-BioNTech
- 2022-10-22
- 2022-10-28
- 2022-11-03
- 2022-11-10
- 2022-11-17
- 2022-11-24
- 2023-01-12
- 2023-04-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-10-15 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
| 5 | 2022-10-13 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
Free text
Release 3 — day 0, dose 1
Systemic reaction (other): Arm muscle is sore to movement
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Muscle ache in arm
Systemic reaction (other): Pain in arm at injection site much less
Systemic reaction (other): Arm is a little tender at injection site.
Release 4 — day 7, dose 1
Systemic reaction (other): UTI
Release 4 — day 21, dose 1
Symptoms: Rash on tops of both breasts and abdomen
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Burning sensation in upper chest
Systemic reaction (other): Muscle spasm in right shoulder
Release 5 — day 7, dose 2
Systemic reaction (other): Chest pain
Release 5 — day 14, dose 2
Symptoms: Chest pain/burning in chest, esophagitis, GERD
Release 11 — day 21, dose 4
Symptoms: Vitreal separation in left eye
Release 12 — 3 months, dose 4
Symptoms: Covid positive on 6/29/22. Took Paxlovid. Rebound positive 7/12/22. Sore throat and cough both times plus headache.
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 |
|---|---|---|---|---|
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Gastrooesophageal reflux disease | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Oesophagitis | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pre-existing disease | ○ | ✓ | ○ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Vitreous detachment | · | · | ✓ |
| SRO | Burning sensation | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Urinary tract infection | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release