2PS-16782-67805
5 vaccinations
7 coded responses
25 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 371 / TN
- Registered
- 2021-01-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Dose 1 — Moderna
-
2021-01-19
Registered in v-safe
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2021-01-19
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-01-22
-
2021-01-29
Survey response — day 14, dose 1MedDRA: Myalgia — Feeling: FairFree text: Muscle painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
-
2021-02-12
Dose 2 — Moderna
- 2021-02-12
- 2021-02-13
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Dyspepsia — Feeling: Good · HeadacheFree text: HeartburnMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
-
2021-02-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-17
Survey response — days 1–6 daily, dose 2MedDRA: Dyspepsia — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: HeartburnMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness, Nausea, DiarrheaAdult check-in
- 2021-02-19
- 2021-02-27
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2021-03-06
Survey response — day 21, dose 2MedDRA: Chest pain — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: I had severe chest pains, which turned out to be a blockage in the heart which required a stent.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Survey response — day 28, dose 2MedDRA: Atrioventricular block, Chest pain, Emergency care, Stent placement — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: I had been having chest pain and it became more severe. I went to a an emergency clinic and was transferred to a hospital, where I went through a series of tests, which identified a blockage and resulted in the placing of a stent.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Report sent to call center — day 28, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-19
- 2021-03-26
- 2021-05-14
- 2021-08-13
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2021-11-09
Dose 3 — Pfizer-BioNTech
-
2021-12-14
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-02-12
-
2022-05-14
Dose 4 — Pfizer-BioNTech
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2022-08-13
Survey response — 3 months, dose 4MedDRA: Adverse drug reaction, Alopecia, Pre-existing disease — Feeling: FairFree text: The new condition is loss of hair that began after my booster shots, and I am now dealing with side effects of stopping the blood thinner I had been taking since the heart attack.MedDRA releases: 2024-11 · check-in free text available
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2022-10-15
Dose 5 — ModernaCo-administered: Flu
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2022-11-12
Survey response — day 28, dose 5MedDRA: Alopecia — Feeling: FairFree text: Loss of hair.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-19
- 2022-11-28
- 2023-01-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna | |
| 3 | 2021-11-09 | Pfizer-BioNTech | No |
| 4 | 2022-05-14 | Pfizer-BioNTech | No |
| 5 | 2022-10-15 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 3 — day 14, dose 1
Symptoms: Muscle pain
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Heartburn
Systemic reaction (other): Heartburn
Release 5 — day 21, dose 2
Symptoms: I had severe chest pains, which turned out to be a blockage in the heart which required a stent.
Release 5 — day 28, dose 2
Symptoms: I had been having chest pain and it became more severe. I went to a an emergency clinic and was transferred to a hospital, where I went through a series of tests, which identified a blockage and resulted in the placing of a stent.
Release 12 — 3 months, dose 4
Symptoms: The new condition is loss of hair that began after my booster shots, and I am now dealing with side effects of stopping the blood thinner I had been taking since the heart attack.
Release 12 — day 28, dose 5
Symptoms: Loss of hair.
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 | Adverse drug reaction | · | · | ✓ |
| SD | Alopecia | · | · | ✓ |
| SD | Atrioventricular block | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Stent placement | ✓ | ✓ | ✓ |
| SRO | Dyspepsia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release