3MF-92381-23353
5 vaccinations
2 coded responses
32 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 945 / CA
- Registered
- 2021-03-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-09
Registered in v-safe
-
2021-03-09
Dose 1 — Moderna
-
2021-03-10
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-03-11
Survey response — days 1–6 daily, dose 1MedDRA: Heart rate increased, Rash — Feeling: Good · Site: Pain, Redness · Fever · Fatigue or tirednessFree text: Last night I had elevated heart rate over 100bpm at rest which I also experienced when I had COVID three month ago. I had rash on my stomach and back last night but it resolved by this morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-18
- 2021-03-23
- 2021-03-30
-
2021-04-06
Dose 2 — Moderna
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-07-07
- 2021-10-05
-
2021-12-15
Dose 3 — Moderna
-
2022-04-06
Survey response — 12 months, dose 2MedDRA: Gastroenteritis viral, Heart rate decreased, Pain, Syncope — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: I had a vaso vagal fairing episode January 7,2022 likely due to extreme pain from a stomach bug. My heart rate had been getting quite low in the weeks prior (as low as 39-41) after a recent escalation in exercise. It has now stabilized and I am fineMedDRA releases: 2024-11 · check-in free text available
-
2022-04-06
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-04-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-15
Dose 4 — Moderna
- 2022-04-26
- 2022-05-08
- 2022-05-20
- 2022-05-27
- 2022-07-15
-
2022-09-09
Dose 5 — Pfizer-BioNTech
- 2022-09-17
- 2022-09-23
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-12-09
- 2023-03-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-09 | Moderna | |
| 2 | 2021-04-06 | Moderna | |
| 3 | 2021-12-15 | Moderna | No |
| 4 | 2022-04-15 | Moderna | No |
| 5 | 2022-09-09 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Last night I had elevated heart rate over 100bpm at rest which I also experienced when I had COVID three month ago. I had rash on my stomach and back last night but it resolved by this morning.
Release 11 — 12 months, dose 2
Symptoms: I had a vaso vagal fairing episode January 7,2022 likely due to extreme pain from a stomach bug. My heart rate had been getting quite low in the weeks prior (as low as 39-41) after a recent escalation in exercise. It has now stabilized and I am fine cut off by CDC
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 | Gastroenteritis viral | · | · | ✓ |
| SD | Heart rate decreased | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Syncope | · | · | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release