2C4-66991-31108
2 vaccinations
8 coded responses
8 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 330 / FL
- Registered
- 2021-12-13
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
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2021-12-09
Dose 1 — Moderna
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2021-12-13
Registered in v-safe
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2021-12-14
Survey response — days 1–6 daily, dose 1MedDRA: Decreased appetite, Dyspnoea — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activitiesFree text: shortness of breath, loss of appetiteMedDRA releases: 2024-11 · check-in free text available
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2021-12-15
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea — Feeling: Poor · Site: Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Shortness of breathMedDRA releases: 2024-11 · check-in free text available
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2022-01-21
Dose 2 — Moderna
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2022-01-22
Survey response — days 1–6 daily, dose 2MedDRA: Asthenia, Back pain, Decreased appetite, Dizziness, Dyspnoea, Eye pain, Insomnia, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: insomnia, shortness of breath, shakey hands, dizzy, back pain, eye pain, weakness, loss of appetite.MedDRA releases: 2024-11 · check-in free text available
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2022-01-23
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite, Dizziness, Dyspnoea, Muscular weakness, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Shortness of breath, muscle weakness, dizzy, no appetite, have the shakesMedDRA releases: 2024-11 · check-in free text available
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2022-01-24
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Dizziness, Dyspnoea, Muscular weakness, Palpitations, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: dizzy, muscle weakness, short of breath, shaking, back pain, heart racing & palpitationsMedDRA releases: 2024-11 · check-in free text available
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2022-01-27
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Decreased appetite, Dizziness, Dyspnoea, Insomnia — Feeling: Fair · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Back pain, dizzy, short of breath, still no appetite, insomnia since 1st dayMedDRA releases: 2024-11 · check-in free text available
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2022-01-28
Survey response — day 7, dose 2MedDRA: Back pain, Decreased appetite, Dizziness, Insomnia — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Still dizzy, still back pain, still insomnia and minimal appetiteMedDRA releases: 2024-11 · check-in free text available
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2022-02-04
Survey response — day 14, dose 2MedDRA: Arthralgia, Dyspnoea, Fatigue, Office visit, Productive cough, Respiratory tract congestion, Visual impairment — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Joint pain (ankles, knees, shoulders) & fatigue have gotten worse. Shortness of breath grew worse with congestion & phlegm. Doc put me on antibiotics & steroids. Unexplained vision problems. Haven't seen eye doc yet. · Healthcare visit (other): PCP & pulmonologistMedDRA releases: 2024-11 · check-in free text available
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2022-02-04
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2022-03-30
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-12-09 | Moderna | No |
| 2 | 2022-01-21 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 10 — days 1–6 daily, dose 1
Systemic reaction (other): shortness of breath, loss of appetite
Systemic reaction (other): Shortness of breath
Release 11 — days 1–6 daily, dose 2
Systemic reaction (other): insomnia, shortness of breath, shakey hands, dizzy, back pain, eye pain, weakness, loss of appetite.
Systemic reaction (other): Shortness of breath, muscle weakness, dizzy, no appetite, have the shakes
Systemic reaction (other): dizzy, muscle weakness, short of breath, shaking, back pain, heart racing & palpitations
Systemic reaction (other): Back pain, dizzy, short of breath, still no appetite, insomnia since 1st day
Release 11 — day 7, dose 2
Systemic reaction (other): Still dizzy, still back pain, still insomnia and minimal appetite
Release 11 — day 14, dose 2
Symptoms: Joint pain (ankles, knees, shoulders) & fatigue have gotten worse. Shortness of breath grew worse with congestion & phlegm. Doc put me on antibiotics & steroids. Unexplained vision problems. Haven't seen eye doc yet.
Healthcare visit (other): PCP & pulmonologist
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 | Arthralgia | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Visual impairment | · | · | ✓ |
| SRO | Asthenia | · | · | ✓ |
| SRO | Back pain | · | · | ✓ |
| SRO | Decreased appetite | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Dyspnoea | · | · | ✓ |
| SRO | Eye pain | · | · | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Muscular weakness | · | · | ✓ |
| SRO | Palpitations | · | · | ✓ |
| SRO | Tremor | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release