2XU-32354-38631
3 vaccinations
6 coded responses
15 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 978 / OR
- Registered
- 2021-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
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2021-12-27
Dose 1 — Moderna
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2021-12-28
Registered in v-safe
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2021-12-29
Survey response — days 1–6 daily, dose 1MedDRA: Anxiety, Chest discomfort, Chest pain, Emotional distress, Lacrimation increased, Renal pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Chest pain and pressure diminished as compared to yesterday's, kidneys pain significantly diminished, increase in symptoms of watery eyes, diminished symptoms of emotional distress and anxiety.MedDRA releases: 2024-11 · check-in free text available
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2022-01-01
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tiredness, Abdominal pain · Be unable to work or attend schoolAdult check-in
- 2022-01-05
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2022-02-02
Survey response — day 35, dose 1MedDRA: Cardiovascular symptom, Office visit — Feeling: Fair · Be unable to work or attend schoolFree text: My doctor has to clear me from possible Myocardysis since I did experience symptoms as described at the CDC website on the Moderna shot. That's the reason the doctor ordered to hold on until I'm cleared. I'm getting the pertinent tests to clear me.MedDRA releases: 2024-11 · check-in free text available
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2022-02-08
Survey response — day 42, dose 1MedDRA: Chest pain, Chills, Cough, Dyspnoea, Fatigue, Headache, Mental impairment, Pain, Pyrexia, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend schoolFree text: Fever, shortness of breath, cough, chills, body aches, extreme exhaustion, inability to think clear, chest pain, congestion, really bad headaches.MedDRA releases: 2024-11 · check-in free text available
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2022-03-01
Dose 2 — Moderna
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2022-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend schoolAdult check-in
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2022-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Abdominal pain · Be unable to work or attend schoolAdult check-in
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2022-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to work or attend schoolAdult check-in
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2022-03-11
Health check-in — day 7, dose 2Feeling: Fair · Site: Itching · Headache, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2022-03-15
Survey response — day 14, dose 2MedDRA: COVID-19, Pre-existing disease, Renal pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I've been having heart qualifications like it once I had when I first took the first Covid vaccination. My doctor says those were similar to the ones for myocarditis. She had my heart checked. Also I been having kidney pain because of Covid.MedDRA releases: 2024-11 · check-in free text available
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2022-03-29
Survey response — day 28, dose 2MedDRA: Ageusia, Cerebrovascular accident, Parosmia, Taste disorder, Unevaluable event — Feeling: FairFree text: Covid symptoms come and go. Sometimes my taste is different or I have no taste at all. What's funny is that I survived a stroke and only half of my thong loosest taste. The same thing with my smell, things smell differently.MedDRA releases: 2024-11 · check-in free text available
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2022-09-12
Dose 3 — Pfizer-BioNTech
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2022-09-13
Survey response — days 1–6 daily, dose 3MedDRA: Chest pain, Cough, Influenza like illness, Nasal congestion, Pain, Renal pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Flu like symptoms, stuffy nose, coughing, Pain all over my internal organs, and severe pain in my kidneys. Chest pain,MedDRA releases: 2024-11 · check-in free text available
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2022-09-16
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Swelling, Itching · Fever · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2022-09-17
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2022-09-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-12-27 | Moderna | No |
| 2 | 2022-03-01 | Moderna | No |
| 3 | 2022-09-12 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 1
Systemic reaction (other): Chest pain and pressure diminished as compared to yesterday's, kidneys pain significantly diminished, increase in symptoms of watery eyes, diminished symptoms of emotional distress and anxiety.
Release 11 — day 35, dose 1
Symptoms: My doctor has to clear me from possible Myocardysis since I did experience symptoms as described at the CDC website on the Moderna shot. That's the reason the doctor ordered to hold on until I'm cleared. I'm getting the pertinent tests to clear me. cut off by CDC
Release 11 — day 42, dose 1
Symptoms: Fever, shortness of breath, cough, chills, body aches, extreme exhaustion, inability to think clear, chest pain, congestion, really bad headaches.
Release 11 — day 14, dose 2
Symptoms: I've been having heart qualifications like it once I had when I first took the first Covid vaccination. My doctor says those were similar to the ones for myocarditis. She had my heart checked. Also I been having kidney pain because of Covid.
Release 11 — day 28, dose 2
Symptoms: Covid symptoms come and go. Sometimes my taste is different or I have no taste at all. What's funny is that I survived a stroke and only half of my thong loosest taste. The same thing with my smell, things smell differently.
Release 12 — days 1–6 daily, dose 3
Systemic reaction (other): Flu like symptoms, stuffy nose, coughing, Pain all over my internal organs, and severe pain in my kidneys. Chest pain,
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 | Ageusia | · | · | ✓ |
| SD | Cardiovascular symptom | · | · | ✓ |
| SD | Cerebrovascular accident | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Mental impairment | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Parosmia | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Renal pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Taste disorder | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Anxiety | · | · | ✓ |
| SRO | Chest discomfort | · | · | ✓ |
| SRO | Chest pain | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Emotional distress | · | · | ✓ |
| SRO | Influenza like illness | · | · | ✓ |
| SRO | Lacrimation increased | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Renal pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release