39W-20519-81302
5 vaccinations
15 coded responses
63 check-ins
15 free-text entries
7 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 775 / TX
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Registered in v-safe
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2021-01-07
Dose 1 — Moderna
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-14
- 2021-01-21
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2021-01-28
Survey response — day 21, dose 1MedDRA: Cough — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: CoughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-28
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-04
Dose 2 — Moderna
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2021-02-04
Survey response — day 0, dose 2MedDRA: Blood pressure decreased — Feeling: Good · Site: PainFree text: BP lower than usual. 118/60 at 7 hours after vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
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2021-02-25
Survey response — day 21, dose 2MedDRA: Cough, Fatigue, Sneezing — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sneezing, cough, fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-25
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-04
Survey response — day 28, dose 2MedDRA: Asthma, Cough, Fatigue, Oropharyngeal pain — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cough. Asthma. Sore throat. FatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Report sent to call center — day 28, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-11
- 2021-03-18
- 2021-05-06
- 2021-06-07
- 2021-06-07
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2021-06-07
Callback requested for07:00PM ET
- 2021-06-07
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2021-06-07
Callback requested for07:00PM ET
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2021-08-05
Survey response — 6 months, dose 2MedDRA: Heart rate increased, Palpitations — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Heart palpitations and rapid heart rate.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 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-16
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2021-10-30
Dose 3 — Moderna
- 2021-10-30
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2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Blood pressure increased — Feeling: Poor · Site: Pain, Swelling · Fever · Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Blood pressure was high this morning.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2021-12-11
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2022-01-29
Survey response — 3 months, dose 3MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: FairFree text: Currently sore throat and nasal congestionMedDRA releases: 2024-11 · check-in free text available
- 2022-04-30
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2022-07-15
Dose 4 — Moderna
- 2022-07-15
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2022-07-16
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2022-07-17
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2022-07-18
- 2022-07-19
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2022-07-20
Survey response — days 1–6 daily, dose 4MedDRA: Cough — Feeling: GoodFree text: Cough last night.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-22
- 2022-07-29
- 2022-08-07
- 2022-08-12
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2022-08-19
Survey response — day 35, dose 4MedDRA: Chest pain — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Chest painsMedDRA releases: 2024-11 · check-in free text available
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2022-08-19
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-08-22
- 2022-08-22
- 2022-08-22
- 2022-08-22
- 2022-08-22
- 2022-08-26
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2022-10-14
Survey response — 3 months, dose 4MedDRA: Bronchitis, Cough, Fatigue, Influenza virus test negative, SARS-CoV-2 test negative, Viral infection — Feeling: Good · Be unable to work or attend schoolFree text: Virus that turned into bronchitis. Tested negative for flu and COVID. Lots of coughing. Severe fatigue.MedDRA releases: 2024-11 · check-in free text available
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2022-10-28
Dose 5 — ModernaCo-administered: Flu
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2022-10-29
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2022-10-30
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2022-10-31
Survey response — days 1–6 daily, dose 5MedDRA: Oral herpes — Feeling: Good · Site: PainFree text: I have had. 2 fever blisters popped up since the day I was vaccinated with the Bivalent booster. 10/28/22. One that evening and one yesterday.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-01
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2022-11-02
Survey response — days 1–6 daily, dose 5MedDRA: Cough — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: CoughMedDRA releases: 2024-11 · check-in free text available
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2022-11-02
Report sent to call center — days 1–6 daily, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-11-03
Survey response — days 1–6 daily, dose 5MedDRA: Cough, Respiratory tract congestion — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Congested coughMedDRA releases: 2024-11 · check-in free text available
- 2022-11-03
- 2022-11-03
- 2022-11-03
- 2022-11-03
- 2022-11-03
- 2022-11-03
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2022-11-04
Survey response — day 7, dose 5MedDRA: Cough — Feeling: Fair · Headache · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: CoughMedDRA releases: 2024-11 · check-in free text available
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2022-11-04
Report sent to call center — day 7, dose 5Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-11-08
Call successfulNot applicable - Accidental Reporting
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2022-11-08
Call successfulNot applicable - Accidental Reporting
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2022-11-08
Call successfulNot applicable - Accidental Reporting
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2022-11-08
Call successfulNot applicable - Accidental Reporting
-
2022-11-08
Call successfulNot applicable - Accidental Reporting
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2022-11-08
Call successfulParticipant prefers to complete VAERS report online
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2022-11-08
Call successfulParticipant prefers to complete VAERS report online
- 2022-11-11
- 2022-11-18
- 2022-11-25
- 2022-12-02
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2022-12-10
Survey response — day 42, dose 5MedDRA: Nasal congestion — Feeling: FairFree text: Stuffy noseMedDRA releases: 2024-11 · check-in free text available
- 2023-01-29
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna | |
| 3 | 2021-10-30 | Moderna | No |
| 4 | 2022-07-15 | Moderna | No |
| 5 | 2022-10-28 | Moderna | Flu |
Call center
7 call center cases
7 successful
3 waits over 3 months for a first call
Free text
Release 3 — day 21, dose 1
Symptoms: Cough
Release 3 — day 0, dose 2
Systemic reaction (other): BP lower than usual. 118/60 at 7 hours after vaccine.
Release 4 — day 21, dose 2
Symptoms: Sneezing, cough, fatigue
Release 5 — day 28, dose 2
Symptoms: Cough. Asthma. Sore throat. Fatigue
Release 9 — 6 months, dose 2
Symptoms: Heart palpitations and rapid heart rate.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Blood pressure was high this morning.
Release 11 — 3 months, dose 3
Symptoms: Currently sore throat and nasal congestion
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Cough last night.
Release 12 — day 35, dose 4
Symptoms: Chest pains
Release 12 — 3 months, dose 4
Symptoms: Virus that turned into bronchitis. Tested negative for flu and COVID. Lots of coughing. Severe fatigue.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): I have had. 2 fever blisters popped up since the day I was vaccinated with the Bivalent booster. 10/28/22. One that evening and one yesterday.
Systemic reaction (other): Cough
Systemic reaction (other): Congested cough
Release 12 — day 7, dose 5
Systemic reaction (other): Cough
Release 12 — day 42, dose 5
Symptoms: Stuffy nose
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 | Asthma | ✓ | ✓ | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Heart rate increased | ✓ | · | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Palpitations | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Blood pressure decreased | ✓ | ✓ | ✓ |
| SRO | Blood pressure increased | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Oral herpes | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release