3AV-63113-78084
2 vaccinations
5 coded responses
21 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 200 / DC
- Registered
- 2021-03-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Registered in v-safe
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2021-03-03
Dose 1 — Moderna
- 2021-03-03
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2021-03-04
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-03-05
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-03-07
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2021-03-08
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-12
Health check-in — day 7, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
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2021-03-17
Survey response — day 14, dose 1MedDRA: Abdominal distension, Abdominal pain lower, Diarrhoea — Feeling: PoorFree text: Bloat, diarrhea, lower abdominal painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Survey response — day 21, dose 1MedDRA: Diarrhoea, Discomfort, Dyspepsia, Muscle spasms — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Diarrhea, digestive discomfort, crampingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-31
Dose 2 — Moderna
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2021-03-31
Survey response — day 0, dose 2MedDRA: Dizziness, Heart rate increased, Heart rate irregular, Paraesthesia, Pruritus — Feeling: Poor · Site: Itching · Be unable to do your normal daily activitiesFree text: Dizzy, my heart rate spiked to 169 while waiting after my shot and then my heart rate kept fluctuating from 90s to 130s for awhile after, still a bit dizzy, skin a little tingly/itchyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
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2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
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2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, Abdominal painAdult check-in
- 2021-04-15
- 2021-04-21
- 2021-04-29
- 2021-05-08
- 2021-05-13
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2021-06-30
Survey response — 3 months, dose 2MedDRA: Abdominal pain, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Pelvic and abdominal pain · Healthcare visit (other): Normal office visitsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-30
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-01
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2021-09-30
Survey response — 6 months, dose 2MedDRA: Fatigue — Feeling: FairFree text: FatigueMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-31 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-24 | Unsuccessful | |
| 2021-06-30 | Unsuccessful |
Free text
Release 5 — day 14, dose 1
Symptoms: Bloat, diarrhea, lower abdominal pain
Release 6 — day 21, dose 1
Symptoms: Diarrhea, digestive discomfort, cramping
Release 6 — day 0, dose 2
Systemic reaction (other): Dizzy, my heart rate spiked to 169 while waiting after my shot and then my heart rate kept fluctuating from 90s to 130s for awhile after, still a bit dizzy, skin a little tingly/itchy
Release 9 — 3 months, dose 2
Release 9 — 6 months, dose 2
Symptoms: Fatigue
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 | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Abdominal pain | ✓ | ✓ | ✓ |
| SD | Abdominal pain lower | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Discomfort | ✓ | · | ✓ |
| SD | Dyspepsia | ○ | ✓ | ○ |
| SD | Fatigue | · | · | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Heart rate irregular | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release