2VH-15392-06403
2 vaccinations
8 coded responses
14 check-ins
8 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 981 / WA
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Dose 1 — Moderna
-
2021-02-04
Dose 2 — Moderna
-
2021-02-05
Registered in v-safe
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2021-02-05
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-05
Report sent to call center — days 1–6 daily, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
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2021-02-08
Survey response — days 1–6 daily, dose 2MedDRA: Oedema peripheral — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: Puffy spot anterior axilla on side of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-09
Survey response — days 1–6 daily, dose 2MedDRA: Oedema peripheral — Feeling: Good · Headache, Fatigue or tiredness, DiarrheaFree text: Swelling of anterior axilla on side of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Oedema peripheral — Feeling: Good · Chills, Headache, Fatigue or tiredness, DiarrheaFree text: Swelling in armpit - mild compared with yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-18
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2021-02-25
Survey response — day 21, dose 2MedDRA: Confusional state — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Mental confusionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-11
- 2021-03-18
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2021-05-06
Survey response — 3 months, dose 2MedDRA: Abdominal discomfort, Anxiety, Decreased appetite, Diarrhoea, Nausea, Tinnitus — Feeling: Fair · Be unable to work, 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 visit, Emergency room or emergency department visitFree text: Tinnitus, GI upset w/ diarrhea, waking early with feeling of impending doom that lasts 3-5 hours, nausea, loss of appetiteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-06
Report sent to call center — 3 months, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-07-03
Call successfulCompleted over the phone
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2021-08-05
Survey response — 6 months, dose 2MedDRA: Dissociative disorder, Panic disorder — Feeling: Poor · 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 visit, Emergency room or emergency department visitFree text: Heightened panic, dissociative episodes. These are new for me Ive never had disassociation before this month.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-05
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)
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2021-08-16
Callback requested for03:05PM ET
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2021-08-16
Call successfulCompleted over the phone
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2022-02-04
Survey response — 12 months, dose 2MedDRA: Periarthritis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Frozen shoulderMedDRA releases: 2024-11 · check-in free text available
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2022-02-04
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-02-08
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2022-02-11
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-04 | Moderna |
Call center
4 call center cases
4 successful
VAERS report filed, before or during a call: 3
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Dizziness
Systemic reaction (other): Puffy spot anterior axilla on side of injection
Systemic reaction (other): Swelling of anterior axilla on side of injection
Systemic reaction (other): Swelling in armpit - mild compared with yesterday
Release 4 — day 21, dose 2
Symptoms: Mental confusion
Release 8 — 3 months, dose 2
Symptoms: Tinnitus, GI upset w/ diarrhea, waking early with feeling of impending doom that lasts 3-5 hours, nausea, loss of appetite
Release 9 — 6 months, dose 2
Symptoms: Heightened panic, dissociative episodes. These are new for me Ive never had disassociation before this month.
Release 11 — 12 months, dose 2
Symptoms: Frozen shoulder
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 | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Anxiety | ✓ | ✓ | ✓ |
| SD | Confusional state | ✓ | ✓ | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dissociative disorder | ✓ | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Panic disorder | ✓ | · | ✓ |
| SD | Periarthritis | · | · | ✓ |
| SD | Tinnitus | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release