2ZE-14537-08790
1 vaccination
7 coded responses
14 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 070 / NJ
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-26
Registered in v-safe
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2021-01-26
Dose 1 — Moderna
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2021-01-26
Survey response — day 0, dose 1MedDRA: Dizziness, Heart rate increased, Hypertension, Office visit, Throat tightness — Feeling: Poor · Site: Pain · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Dizziness. Increased heart rate, high blood pressure, tightening of throat · Healthcare visit (other): Doctors office - had ekg and shot of BenadrylMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Report sent to call center — day 0, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-27
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Heart rate irregular — Feeling: Fair · Site: Pain, RednessFree text: Dizziness, irregular heart beatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-28
Survey response — days 1–6 daily, dose 1MedDRA: Heart rate irregular, Hypertension — Feeling: Poor · Site: Pain, Redness · Abdominal pain · Be unable to do your normal daily activitiesFree text: Rapid irregular heart rate, high blood pressureMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-29
Survey response — days 1–6 daily, dose 1MedDRA: Heart rate irregular — Feeling: FairFree text: Irregular heart beat less than the past few daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-30
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea, Heart rate irregular — Feeling: FairFree text: Slight shortness of breath and still periodic irregular heartbeatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-31
Survey response — days 1–6 daily, dose 1MedDRA: Heart rate irregular — Feeling: Good · Site: RednessFree text: Much less irregular heart beat but still happens occasionally out of nowhereMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
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2021-02-09
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Medical counselling, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Red, itchy, hot soreness at sight of injection 8 days following vaccine. This last 3 days and the redness covered a good portion beyond injection site. I saw the Dr in person and had a telemed visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-09
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
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2021-04-10
Call successfulParticipant prefers to complete VAERS report online
- 2021-04-27
- 2021-07-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): Dizziness. Increased heart rate, high blood pressure, tightening of throat
Healthcare visit (other): Doctors office - had ekg and shot of Benadryl
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Dizziness, irregular heart beat
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Rapid irregular heart rate, high blood pressure
Systemic reaction (other): Irregular heart beat less than the past few days
Systemic reaction (other): Slight shortness of breath and still periodic irregular heartbeat
Systemic reaction (other): Much less irregular heart beat but still happens occasionally out of nowhere
Release 3 — day 14, dose 1
Symptoms: Red, itchy, hot soreness at sight of injection 8 days following vaccine. This last 3 days and the redness covered a good portion beyond injection site. I saw the Dr in person and had a telemed visit
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
| SD | Medical counselling | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Heart rate irregular | ✓ | ✓ | ✓ |
| SRO | Hypertension | ✓ | ✓ | ✓ |
| SRO | Throat tightness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release