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3TF-20258-12648

2 vaccinations 5 coded responses 11 check-ins 5 free-text entries 2 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
805 / CO
Registered
2021-05-27
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-29
    Dose 1 — Moderna
  2. 2021-05-27
    Registered in v-safe
  3. 2021-05-27
    Dose 2 — Moderna
  4. 2021-05-27
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-05-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  6. 2021-05-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-05-30
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Swelling, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-05-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches
    Adult check-in
  9. 2021-06-05
    Survey response — day 7, dose 2
    MedDRA: Dyspnoea — Feeling: Good · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Mildly out of breath easily for a couple days
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-06-10
    Survey response — day 14, dose 2
    MedDRA: Cognitive disorder, Dysphemia, Memory impairment — Feeling: Good
    Free text: I have noticed some cognitive issues. Like memory impairment just the occasional word or stutter which is not normal for me.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-06-17
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-07-03
    Survey response — day 35, dose 2
    MedDRA: Headache, Pre-existing disease, Sinus disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Sinus and allergy problems headaches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-07-03
    Report sent to call center — day 35, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  14. 2021-07-07
    Call successful
    Participant prefers to complete VAERS report online
  15. 2021-07-08
    Survey response — day 42, dose 2
    MedDRA: Aphasia, Chiropractic, Coordination abnormal, Grip strength decreased, Nervous system disorder, Physiotherapy, Vision blurred — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: some minor neurological glitches. this has been since the first shot. Dropping words That I should know , some coordination and fine motor in my hands. Im dropping things. minor vision blurring in the periphery and in 1 eye · Healthcare visit (other): Some physical therapy and chiropractic
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-07-08
    Report sent to call center — day 42, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-07-13
  18. 2021-11-25
    Survey response — 6 months, dose 2
    MedDRA: Dyspnoea exertional — Feeling: Good · Be unable to do your normal daily activities
    Free text: Shortness of breath with mild exertion
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-04-29Moderna
22021-05-27Moderna

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 8 — day 7, dose 2

2021-06-05

Systemic reaction (other): Mildly out of breath easily for a couple days

Release 9 — day 14, dose 2

2021-06-10

Symptoms: I have noticed some cognitive issues. Like memory impairment just the occasional word or stutter which is not normal for me.

Release 9 — day 35, dose 2

2021-07-03

Symptoms: Sinus and allergy problems headaches

Release 9 — day 42, dose 2

2021-07-08

Symptoms: some minor neurological glitches. this has been since the first shot. Dropping words That I should know , some coordination and fine motor in my hands. Im dropping things. minor vision blurring in the periphery and in 1 eye
Healthcare visit (other): Some physical therapy and chiropractic

Release 10 — 6 months, dose 2

2021-11-25

Symptoms: Shortness of breath with mild exertion

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

FieldPreferred term2021-092023-042024-11
HCVOChiropractic ✓ ✓ ✓
HCVOPhysiotherapy ✓ ✓ ✓
SDAphasia ✓ ✓ ✓
SDCognitive disorder ✓ ✓ ✓
SDCoordination abnormal ✓ ✓ ✓
SDDysphemia ✓ ✓ ✓
SDDyspnoea exertional · · ✓
SDGrip strength decreased ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDMemory impairment ✓ ✓ ✓
SDNervous system disorder ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDSinus disorder ✓ ✓ ✓
SDVision blurred ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release