3MS-18290-47176
2 vaccinations
2 coded responses
25 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 930 / CA
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-03-19
Registered in v-safe
-
2021-03-19
Dose 1 — Moderna
- 2021-03-19
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-04-02
- 2021-04-09
-
2021-04-16
Dose 2 — Moderna
-
2021-04-16
Survey response — day 0, dose 2MedDRA: Dizziness, Immediate post-injection reaction, Injection site reaction, Medical observation, Musculoskeletal stiffness, Self-medication — Feeling: Fair · Site: Swelling · Fatigue or tiredness · Be unable to work, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Dizziness at 20 min, then at 35 min stiffness traveling up from injection site to shoulder, up neck, across both brows, both cheeks, around eyes, tip of ears, jaw joint, the tip of nose, upper lip, upper gums, down to tips of front teeth. Stiffness was severe and was increasing to more areas until i took 25 mg benadryl which relieved spread of stiffness with 10 minutes of taking pill. I rem as ined for observation for 2 1/2 hr after shot untul stiffness receded. After 6 hrs, only my nose and gums feel stiff and teeth feel stiff. · Healthcare visit (other): Sought help from onsite nurses and EMTMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-16
Report sent to call center — day 0, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
-
2021-05-22
Survey response — day 35, dose 2MedDRA: Office visit, Vitreous detachment — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I went to retinal specialist who diagnosed my right eye as having experienced a posterior vitreous detachment. · Healthcare visit (other): In office retinal specialist visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-22
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-01
- 2021-07-16
- 2021-10-15
- 2022-04-09
- 2022-04-16
-
2022-05-10
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-19 | Moderna | |
| 2 | 2021-04-16 | Moderna |
Call center
2 call center cases
2 successful
1 wait over 3 months for a first call
Free text
Release 7 — day 0, dose 2
Systemic reaction (other): Dizziness at 20 min, then at 35 min stiffness traveling up from injection site to shoulder, up neck, across both brows, both cheeks, around eyes, tip of ears, jaw joint, the tip of nose, upper lip, upper gums, down to tips of front teeth. Stiffness was severe and was increasing to more areas until i took 25 mg benadryl which relieved spread of stiffness with 10 minutes of taking pill. I rem as ined for observation for 2 1/2 hr after shot untul stiffness receded. After 6 hrs, only my nose and gums feel stiff and teeth feel stiff.
Healthcare visit (other): Sought help from onsite nurses and EMT
Release 8 — day 35, dose 2
Symptoms: I went to retinal specialist who diagnosed my right eye as having experienced a posterior vitreous detachment.
Healthcare visit (other): In office retinal specialist 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 | Medical observation | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Vitreous detachment | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Injection site reaction | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release