2X4-63231-79817
3 vaccinations
8 coded responses
30 check-ins
8 free-text entries
7 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 784 / TX
- Registered
- 2021-02-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Dose 1 — Moderna
-
2021-02-24
Registered in v-safe
- 2021-02-24
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2021-02-25
Dose 2 — Moderna
- 2021-02-26
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2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
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2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Medical counselling, Urticaria — Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Hives last night · Healthcare visit (other): Call my pharmacist.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-28
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-03
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2021-03-04
Survey response — day 7, dose 2MedDRA: Pruritus — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: ItchMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-10
- 2021-05-27
- 2021-08-26
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2021-09-10
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2021-10-25
Dose 3 — Moderna
- 2021-10-26
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
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2021-11-08
Survey response — day 14, dose 3MedDRA: Neuralgia, Neuropathy peripheral, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Neuropathy is worse. Nerve pain. · Healthcare visit (other): Doctor's officeMedDRA releases: 2024-11 · check-in free text available
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2021-11-08
Report sent to call center — day 14, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-09
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2021-11-10
Callback requested for03:00PM ET
-
2021-11-10
Call successfulCompleted over the phone
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2021-11-15
Survey response — day 21, dose 3MedDRA: Neuralgia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, HospitalizationFree text: Back nerve pain but had injection at surgical center so I willing feel better soon.MedDRA releases: 2024-11 · check-in free text available
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2021-11-15
Report sent to call center — day 21, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Hospitalization · 1 call case(s)
- 2021-11-17
- 2021-11-22
- 2021-11-29
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2021-12-06
Survey response — day 42, dose 3MedDRA: Office visit, Sciatica — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Sciatic never pain · Healthcare visit (other): Office visitMedDRA releases: 2024-11 · check-in free text available
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2021-12-06
Report sent to call center — day 42, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-12-07
Call successfulDoes not wish to fill out VAERS report
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2022-01-24
Survey response — 3 months, dose 3MedDRA: Breast cancer, Office visit — Feeling: Good · 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: Symptoms: Breast cancer · Healthcare visit (other): Doctors visit, mammogram, ultrasound, biopsy, injection in backMedDRA releases: 2024-11 · check-in free text available
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2022-01-24
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-25
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2022-01-26
Call successfulReported to VAERS voluntarily prior to GDIT contact
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2022-04-25
Survey response — 6 months, dose 3MedDRA: Breast cancer — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Breast cancerMedDRA releases: 2024-11 · check-in free text available
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2022-04-25
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
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2022-04-28
Call successfulReported to VAERS during previous contact from GDIT
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2022-10-25
Survey response — 12 months, dose 3MedDRA: Breast cancer, Colon cancer, Radiotherapy, Surgery — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, HospitalizationFree text: Symptoms: I had breast cancer in January and I now have colon cancer. Two cancers in one year. I am wondering about them. · Healthcare visit (other): Surgery and radiation.MedDRA releases: 2024-11 · check-in free text available
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2022-10-25
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Hospitalization · 1 call case(s)
- 2022-10-27
- 2022-11-01
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2022-11-07
Callback requested for04:00PM ET
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2022-11-07
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-25 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
Call center
7 call center cases
6 successful · 1 unsuccessful
VAERS report filed, before or during a call: 5
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Hives last night
Healthcare visit (other): Call my pharmacist.
Release 5 — day 7, dose 2
Systemic reaction (other): Itch
Release 10 — day 14, dose 3
Release 10 — day 21, dose 3
Symptoms: Back nerve pain but had injection at surgical center so I willing feel better soon.
Release 10 — day 42, dose 3
Release 11 — 3 months, dose 3
Symptoms: Breast cancer
Healthcare visit (other): Doctors visit, mammogram, ultrasound, biopsy, injection in back
Release 11 — 6 months, dose 3
Symptoms: Breast cancer
Release 12 — 12 months, dose 3
Symptoms: I had breast cancer in January and I now have colon cancer. Two cancers in one year. I am wondering about them.
Healthcare visit (other): Surgery and radiation.
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 | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Radiotherapy | · | · | ✓ |
| HCVO | Surgery | · | · | ✓ |
| SD | Breast cancer | · | · | ✓ |
| SD | Colon cancer | · | · | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SD | Neuropathy peripheral | · | · | ✓ |
| SD | Sciatica | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release