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2H9-33248-86641

1 vaccination 3 coded responses 6 check-ins 3 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
992 / WA
Registered
2021-02-04
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-02
    Dose 1 — Moderna
  2. 2021-02-04
    Registered in v-safe
  3. 2021-02-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dysgeusia, Fatigue, Hypersomnia, Immediate post-injection reaction, Musculoskeletal stiffness, Non-cardiac chest pain, Pain in extremity, Painful respiration — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Pain in both arms and chest(not cardiac) when I take a breath, not the worst pain but noted, the other noticeable change is Im muscle stiff. The day after the shot I was at severe level. Also very tired and slept a good portion of the day away. The only other thing that I noticed was a peculiar taste in my mouth shortly after the shot it went away within 10-15 minutes.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  5. 2021-02-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  6. 2021-02-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Fatigue — Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Free text: Sooooo tired
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-08-03
    Health check-in — 6 months, dose 1
    Feeling: Fair
    Adult check-in
  8. 2022-02-03
    Survey response — 12 months, dose 1
    MedDRA: Emergency care, Exposure to SARS-CoV-2, Kidney infection, Nephrolithiasis, Quarantine, Respiratory failure — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Sept. 2021 ER for respiratory failure. Jan. 2022 ER for kidney stone and a kidney infection. While in the ER was exposed to Covid then had to quarantine for 2 weeks.
    MedDRA releases: 2024-11 · check-in free text available
  9. 2022-02-03
    Report sent to call center — 12 months, dose 1
    Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  10. 2022-02-04
  11. 2022-02-07
  12. 2022-02-08
  13. 2022-02-17
  14. 2022-02-17
    Call successful
    Completed over the phone

Vaccinations

DoseDateManufacturerCo-administered
12021-02-02Moderna

Call center

1 call center case

1 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Pain in both arms and chest(not cardiac) when I take a breath, not the worst pain but noted, the other noticeable change is Im muscle stiff. The day after the shot I was at severe level. Also very tired and slept a good portion of the day away. The only other thing that I noticed was a peculiar taste in my mouth shortly after the shot it went away within 10-15 minutes.

2021-02-07

Systemic reaction (other): Sooooo tired

Release 11 — 12 months, dose 1

2022-02-03

Symptoms: Sept. 2021 ER for respiratory failure. Jan. 2022 ER for kidney stone and a kidney infection. While in the ER was exposed to Covid then had to quarantine for 2 weeks.

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

FieldPreferred term2021-092023-042024-11
SDEmergency care · · ✓
SDExposure to SARS-CoV-2 · · ✓
SDKidney infection · · ✓
SDNephrolithiasis · · ✓
SDQuarantine · · ✓
SDRespiratory failure · · ✓
SRODysgeusia ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHypersomnia ✓ ✓ ✓
SROImmediate post-injection reaction ✓ ✓ ✓
SROMusculoskeletal stiffness ✓ ✓ ✓
SRONon-cardiac chest pain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPainful respiration ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release