34F-20080-81651
3 vaccinations
5 coded responses
23 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 303 / GA
- Registered
- 2021-01-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Dose 1 — Moderna
-
2021-01-24
Registered in v-safe
- 2021-01-24
- 2021-01-27
- 2021-02-02
-
2021-02-06
Dose 2 — Moderna
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Headache, Pain — Feeling: Good · Site: Pain, Swelling · HeadacheFree text: I had headache, body aches, fatigue on the evening of and day after the vaccine, but have been fine sinceMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-22
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-22
- 2021-05-10
- 2021-08-09
-
2021-10-30
Dose 3 — ModernaCo-administered: Flu
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Paraesthesia — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Tingling in handsMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
-
2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
- 2021-11-04
- 2021-11-08
- 2021-11-13
- 2021-11-20
-
2021-11-27
Survey response — day 28, dose 3MedDRA: Fatigue — Feeling: GoodFree text: FatiguedMedDRA releases: 2024-11 · check-in free text available
- 2021-12-11
-
2022-01-29
Survey response — 3 months, dose 3MedDRA: Autoimmune disorder, COVID-19, Fatigue, Neuropathy peripheral, Office visit, SARS-CoV-2 test positive — 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, Outpatient clinic or urgent care clinic visitFree text: Symptoms: I tested positive for Covid on Dec 22. This then made some mild Neuropathy much worse and also caused major fatigue · Healthcare visit (other): Saw specialist for neuropathy and learned probable auto immune disease and Covid triggered the flareMedDRA releases: 2024-11 · check-in free text available
-
2022-01-29
Report sent to call center — 3 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-02-02
-
2022-02-04
Call successfulCompleted over the phone
-
2022-11-02
Survey response — 12 months, dose 3MedDRA: Inflammation, Office visit, Rash — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Figured out that rash and inflammation I've had since vaccines could also be triggered by wine · Healthcare visit (other): Neurologist and rheumatologist and dermatologistMedDRA releases: 2024-11 · check-in free text available
-
2022-11-02
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2022-11-03
-
2022-12-19
Call successfulReported to VAERS during previous contact from GDIT
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-06 | Moderna | |
| 3 | 2021-10-30 | Moderna | Flu |
Call center
2 call center cases
2 successful
VAERS report filed, before or during a call: 2
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): I had headache, body aches, fatigue on the evening of and day after the vaccine, but have been fine since
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Tingling in hands
Release 10 — day 28, dose 3
Symptoms: Fatigued
Release 11 — 3 months, dose 3
Symptoms: I tested positive for Covid on Dec 22. This then made some mild Neuropathy much worse and also caused major fatigue
Healthcare visit (other): Saw specialist for neuropathy and learned probable auto immune disease and Covid triggered the flare
Release 12 — 12 months, dose 3
Symptoms: Figured out that rash and inflammation I've had since vaccines could also be triggered by wine
Healthcare visit (other): Neurologist and rheumatologist and dermatologist
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 | Autoimmune disorder | · | · | ✓ |
| HCVO | COVID-19 | · | · | ✓ |
| HCVO | Neuropathy peripheral | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Inflammation | · | · | ✓ |
| SD | Neuropathy peripheral | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release