3SL-13367-66198
2 vaccinations
7 coded responses
8 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 346 / FL
- Registered
- 2021-03-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-02
Dose 1 — Moderna
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2021-03-29
Registered in v-safe
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2021-03-29
Survey response — day 21, dose 1MedDRA: Anxiety, Asthenia, Dizziness, Fatigue, Immediate post-injection reaction, Palpitations, Paraesthesia, Tremor, Vision blurred — Feeling: Fair · Be unable to do your normal daily activitiesFree text: This is my 1st checkin. Immediately after the shot on the 2nd my vision was blurry, scalp felt tingling, I was shaky and almost lightheaded. Symptoms better in about 15 minutes. 1st wk palpitations, uneasy, shaky, weak, fatigued.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-30
Dose 2 — Moderna
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2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-04-07
Survey response — day 7, dose 2MedDRA: Dyspepsia, Nasal congestion, Palpitations — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Palpitations; heartburn; stuffy sinusesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Survey response — day 14, dose 2MedDRA: Balance disorder, Chills, Dizziness, Dyspepsia, Fatigue, Headache, Nasal congestion, Nausea, Oral mucosal exfoliation, Palpitations, Respiratory tract congestion, Skin exfoliation — Feeling: Good · Be unable to do your normal daily activitiesFree text: Several headaches; phlegm/chest/nasal congestion; minor disturbing lightheadedness; fatigue; brief nausea episodes; unsteady on feet, as though internal gyroscope was out of kilter; chills; palpitations; extreme heartburn; peeling skin in mouthMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-26
Survey response — day 21, dose 2MedDRA: Dyspepsia, Headache, Malaise, Pain in jaw, Palpitations — Feeling: Good · Be unable to do your normal daily activitiesFree text: Jaw ached about 2 hrs; palpitations 2 days; heartburn; malaise; headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-03
Survey response — day 28, dose 2MedDRA: Headache, Malaise, Nasal congestion — Feeling: Good · Be unable to do your normal daily activitiesFree text: Headache, malaise, nasal congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-10
Survey response — day 35, dose 2MedDRA: Arthralgia, Joint stiffness, Vertigo — Feeling: GoodFree text: Mild Vertigo; stiff, achy knees.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-03
Survey response — 3 months, dose 2MedDRA: Arrhythmia, Brain fog, Dizziness, Fatigue, Headache, Productive cough, Upper-airway cough syndrome — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Intermittent lightheadedness; post nasal drip; sometimes unsteady when walking or standing up; lots of phlegm; daily headaches; odd heartbeats at times, almost like a flutter; fatigue; brain fog; all intermittent.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna |
Free text
Release 6 — day 21, dose 1
Symptoms: This is my 1st checkin. Immediately after the shot on the 2nd my vision was blurry, scalp felt tingling, I was shaky and almost lightheaded. Symptoms better in about 15 minutes. 1st wk palpitations, uneasy, shaky, weak, fatigued.
Release 7 — day 7, dose 2
Systemic reaction (other): Palpitations; heartburn; stuffy sinuses
Release 7 — day 14, dose 2
Symptoms: Several headaches; phlegm/chest/nasal congestion; minor disturbing lightheadedness; fatigue; brief nausea episodes; unsteady on feet, as though internal gyroscope was out of kilter; chills; palpitations; extreme heartburn; peeling skin in mouth
Release 8 — day 21, dose 2
Symptoms: Jaw ached about 2 hrs; palpitations 2 days; heartburn; malaise; headache.
Release 8 — day 28, dose 2
Symptoms: Headache, malaise, nasal congestion
Release 8 — day 35, dose 2
Symptoms: Mild Vertigo; stiff, achy knees.
Release 9 — 3 months, dose 2
Symptoms: Intermittent lightheadedness; post nasal drip; sometimes unsteady when walking or standing up; lots of phlegm; daily headaches; odd heartbeats at times, almost like a flutter; fatigue; brain fog; all intermittent.
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 | Anxiety | ✓ | ✓ | ✓ |
| SD | Arrhythmia | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Balance disorder | ✓ | ✓ | ✓ |
| SD | Brain fog | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyspepsia | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SD | Joint stiffness | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Oral mucosal exfoliation | ✓ | ✓ | ✓ |
| SD | Pain in jaw | ✓ | ✓ | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Paraesthesia | ✓ | ✓ | ✓ |
| SD | Productive cough | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | Skin exfoliation | ✓ | ✓ | ✓ |
| SD | Tremor | ✓ | ✓ | ✓ |
| SD | Upper-airway cough syndrome | ✓ | ✓ | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SD | Vision blurred | ✓ | ✓ | ✓ |
| SRO | Dyspepsia | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release