3X3-22181-09707
5 vaccinations
20 coded responses
50 check-ins
19 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 911 / CA
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Registered in v-safe
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2021-01-26
Dose 1 — Moderna
- 2021-01-26
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2021-01-27
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Nausea, Abdominal painAdult check-in
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2021-01-28
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Abdominal painAdult check-in
- 2021-01-29
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2021-01-30
Survey response — days 1–6 daily, dose 1MedDRA: Nasal congestion — Feeling: FairFree text: Swollen nasal passagesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-31
Survey response — days 1–6 daily, dose 1MedDRA: Nasal congestion — Feeling: GoodFree text: Nasal congestion. MildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-01
- 2021-02-02
- 2021-02-09
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2021-02-16
Survey response — day 21, dose 1MedDRA: Arthralgia, Joint stiffness — Feeling: FairFree text: Joint stiffness/aches. Not typical for me. I am very active.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-23
Dose 2 — Moderna
- 2021-02-23
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2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Tinnitus — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Increased tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Increased tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness, Tinnitus — Feeling: GoodFree text: Dizziness, tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Paranasal sinus discomfort, Tinnitus — Feeling: GoodFree text: Tinnitus, nasal pressureMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Nasal congestion — Feeling: FairFree text: Severe nasal congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Nasal congestion, Tinnitus — Feeling: GoodFree text: Nasal congestion, tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
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2021-03-09
Survey response — day 14, dose 2MedDRA: Joint stiffness — Feeling: GoodFree text: Unusual joint stiffness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-23
- 2021-03-30
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2021-04-06
Survey response — day 42, dose 2MedDRA: Joint stiffness, Musculoskeletal stiffness — Feeling: Fair · 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: Joint stiffness everywhere. Have not experienced this before now. Severe lower back stiffnesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-06
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-25
- 2021-08-24
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2021-10-25
Dose 3 — Moderna
- 2021-10-27
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2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain — Feeling: GoodFree text: Mild tenderness at the injection siteMedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
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2021-11-22
Survey response — day 28, dose 3MedDRA: Blood pressure increased, Vertigo — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Vertigo, increase in BPMedDRA releases: 2024-11 · check-in free text available
- 2021-11-29
- 2021-12-06
- 2022-01-24
- 2022-03-18
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2022-03-18
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-04-25
Survey response — 6 months, dose 3MedDRA: Joint stiffness, Musculoskeletal discomfort — Feeling: Fair · 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: Stiff joints. Very uncomfortable.MedDRA releases: 2024-11 · check-in free text available
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2022-04-25
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-04-26
Call successfulParticipant prefers to complete VAERS report online
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2022-04-29
Dose 4 — Moderna
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2022-05-16
Survey response — day 14, dose 4MedDRA: Fatigue, Joint stiffness — Feeling: FairFree text: Increased fatigue, joint stiffnessMedDRA releases: 2024-11 · check-in free text available
- 2022-05-22
- 2022-05-27
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2022-06-03
Survey response — day 35, dose 4MedDRA: Abdominal pain, Diarrhoea, Headache, Joint stiffness — Feeling: FairFree text: Severe Abdominal cramping, diarrhea, kild headaches, joint stiffnessMedDRA releases: 2024-11 · check-in free text available
- 2022-06-10
- 2022-07-29
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2022-09-08
Dose 5 — Moderna
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2022-09-23
Survey response — day 14, dose 5MedDRA: Decreased appetite, Diarrhoea, Dizziness, Fatigue, Pyrexia, Vertigo — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Following the vaccine: attack of vertigo, 11 days of dizzy episodes, fevers, lack of appetite, diarrhea, extreme fatigueMedDRA releases: 2024-11 · check-in free text available
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2022-09-29
Survey response — day 21, dose 5MedDRA: Balance disorder, Blood pressure increased, Dizziness, Heart rate increased, Office visit, Pyrexia, Vertigo — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: A second attack of vertigo. Episodes of feeling off balance / mild dizziness. Fevers are gone. Periods of sudden rapid heart rate and sudden high blood pressure have stopped. · Healthcare visit (other): Office visit with PCPMedDRA releases: 2024-11 · check-in free text available
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2022-09-29
Report sent to call center — day 21, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2022-09-30
Call successfulReported to VAERS voluntarily prior to GDIT contact
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2022-10-06
Survey response — day 28, dose 5MedDRA: Abdominal pain, Pyrexia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Fever, abdominal pain lasting two daysMedDRA releases: 2024-11 · check-in free text available
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2022-10-06
Report sent to call center — day 28, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-10-07
Call successfulCompleted over the phone
- 2022-10-13
- 2022-10-21
- 2022-12-08
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2023-03-09
Survey response — 6 months, dose 5MedDRA: Joint stiffness, Vertigo — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-23 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-29 | Moderna | No |
| 5 | 2022-09-08 | Moderna | No |
Call center
4 call center cases
4 successful
VAERS report filed, before or during a call: 2
1 wait over 3 months for a first call
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Swollen nasal passages
Systemic reaction (other): Nasal congestion. Mild
Release 4 — day 21, dose 1
Symptoms: Joint stiffness/aches. Not typical for me. I am very active.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Increased tinnitus
Systemic reaction (other): Increased tinnitus
Systemic reaction (other): Dizziness, tinnitus
Systemic reaction (other): Tinnitus, nasal pressure
Systemic reaction (other): Severe nasal congestion
Systemic reaction (other): Nasal congestion, tinnitus
Release 5 — day 14, dose 2
Symptoms: Unusual joint stiffness.
Release 7 — day 42, dose 2
Symptoms: Joint stiffness everywhere. Have not experienced this before now. Severe lower back stiffnes
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Mild tenderness at the injection site
Release 10 — day 28, dose 3
Symptoms: Vertigo, increase in BP
Release 11 — 6 months, dose 3
Symptoms: Stiff joints. Very uncomfortable.
Release 11 — day 14, dose 4
Symptoms: Increased fatigue, joint stiffness
Release 11 — day 35, dose 4
Symptoms: Severe Abdominal cramping, diarrhea, kild headaches, joint stiffness
Release 12 — day 14, dose 5
Symptoms: Following the vaccine: attack of vertigo, 11 days of dizzy episodes, fevers, lack of appetite, diarrhea, extreme fatigue
Release 12 — day 21, dose 5
Symptoms: A second attack of vertigo. Episodes of feeling off balance / mild dizziness. Fevers are gone. Periods of sudden rapid heart rate and sudden high blood pressure have stopped.
Healthcare visit (other): Office visit with PCP
Release 12 — day 28, dose 5
Symptoms: Fever, abdominal pain lasting two days
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 | Office visit | · | · | ✓ |
| SD | Abdominal pain | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Balance disorder | · | · | ✓ |
| SD | Blood pressure increased | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Heart rate increased | · | · | ✓ |
| SD | Joint stiffness | ✓ | ✓ | ✓ |
| SD | Musculoskeletal discomfort | · | · | ✓ |
| SD | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Vertigo | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Paranasal sinus discomfort | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release