3QZ-67313-27380
2 vaccinations
5 coded responses
6 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 16-20
- ZIP prefix
- 064 / CT
- Registered
- 2021-04-22
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- N/A
Timeline
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2021-03-17
Dose 1 — Moderna
-
2021-04-21
Dose 2 — Moderna
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2021-04-22
Registered in v-safe
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2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Injection site bruising — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Bruise where shot wasMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-25
Survey response — days 1–6 daily, dose 2MedDRA: Respiratory tract congestion, Upper-airway cough syndrome — Feeling: Poor · Headache, Joint pains, Muscle or body achesFree text: Congestion , post nasal dripMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-27
Survey response — days 1–6 daily, dose 2MedDRA: Nasopharyngitis — Feeling: Poor · Site: Redness · Be unable to do your normal daily activitiesFree text: Head coldMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Survey response — day 7, dose 2MedDRA: Nasopharyngitis — Feeling: Poor · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to workFree text: Severe head coldMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-12
Survey response — day 21, dose 2MedDRA: Cough, Eye pain, Facial pain, Malaise, Oropharyngeal pain, Pain — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Worsening. Still sick , my face heart eyes nose and throat hurt. I have a terrible coughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-12
Report sent to call center — day 21, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-27
- 2021-06-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-21 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-12 | Unsuccessful |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Bruise where shot was
Systemic reaction (other): Congestion , post nasal drip
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Head cold
Release 8 — day 7, dose 2
Systemic reaction (other): Severe head cold
Release 8 — day 21, dose 2
Symptoms: Worsening. Still sick , my face heart eyes nose and throat hurt. I have a terrible cough
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 | Cough | ✓ | ✓ | ✓ |
| SD | Eye pain | ✓ | ✓ | ✓ |
| SD | Facial pain | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Nasopharyngitis | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Upper-airway cough syndrome | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release