49W-33048-74833
5 vaccinations
9 coded responses
42 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 981 / WA
- Registered
- 2021-04-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-10
Registered in v-safe
-
2021-04-10
Dose 1 — Moderna
- 2021-04-10
- 2021-04-11
-
2021-04-12
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-04-13
- 2021-04-14
- 2021-04-15
-
2021-04-16
Survey response — days 1–6 daily, dose 1MedDRA: Back pain — Feeling: GoodFree text: low back pain (muscles)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
-
2021-04-24
Survey response — day 14, dose 1MedDRA: Back pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: low back painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-01
Survey response — day 21, dose 1MedDRA: Dizziness — Feeling: GoodFree text: Multiple short episodes of dizziness per day, mostly WITHOUT changing vertical position first (!!!), (very odd), mostly while standing or lying down (rarely sitting). I think usually while or shortly after turning? Duration 310 s, frequency 2x8MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-08
Dose 2 — Moderna
- 2021-05-08
-
2021-05-09
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-05-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-05-11
- 2021-05-12
- 2021-05-14
- 2021-05-16
- 2021-05-23
- 2021-05-29
- 2021-06-05
- 2021-06-12
- 2021-06-19
-
2021-08-07
Survey response — 3 months, dose 2MedDRA: Asthenia, Chills, Fatigue, Headache, Nausea, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activitiesFree text: Fatigue & weakness; mild nausea; headache; chills onset was 6 to 8 h after eating shellfish & duration was <18 h my COVID-19 sample taken ~26 h after the meal tested negative.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-11-06
-
2021-12-07
Dose 3 — Janssen/Johnson & Johnson
-
2022-04-23
Dose 4 — Moderna
- 2022-04-28
- 2022-04-29
- 2022-04-30
- 2022-05-08
- 2022-05-14
-
2022-05-21
Survey response — day 28, dose 4MedDRA: Back pain, Unevaluable event, Urinary incontinence — Feeling: Good · Be unable to work or attend school, 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: (most likely completely unrelated) 3 or 4 days of bad low-back pain + accompanying moderately severe urinary incontinence resolved with rest; standing & walking or lying flat instead of sitting & slouching; & prescription NSAIDMedDRA releases: 2024-11 · check-in free text available
-
2022-05-21
Report sent to call center — day 28, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-05-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-28
- 2022-06-04
- 2022-07-23
-
2022-10-22
Survey response — 6 months, dose 4MedDRA: COVID-19, Cough, Disturbance in attention, Dizziness, Dyspnoea, Fatigue, Oropharyngeal pain, Pyrexia, Vertigo — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: *covid-19 (with symptoms of sore throat, cough, fatigue, shortness of breath, poor concentration, fever) * lingering shortness of breath * & new attitudinal vertigo/ dizziness (starting 1 or 2 weeks after negative RCT again) which continues nowMedDRA releases: 2024-11 · check-in free text available
-
2022-10-22
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-10-26
-
2022-10-27
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-12-03
Dose 5 — Pfizer-BioNTech
- 2022-12-10
- 2022-12-17
- 2022-12-24
- 2022-12-31
-
2023-01-07
Survey response — day 35, dose 5MedDRA: Cognitive disorder — Feeling: GoodMedDRA releases: 2024-11
-
2023-01-14
Survey response — day 42, dose 5MedDRA: Cognitive disorder, Loss of personal independence in daily activities, Visuospatial deficit — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
-
2023-03-04
Survey response — 3 months, dose 5MedDRA: Cough, Diarrhoea, Fatigue, Impaired work ability, Influenza A virus test negative, Myalgia, Pyrexia, SARS-CoV-2 test negative, Telemedicine — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-03-04
Report sent to call center — 3 months, dose 5Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-03-06
-
2023-03-06
Call successfulDoes not wish to fill out VAERS report
- 2023-06-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-10 | Moderna | |
| 2 | 2021-05-08 | Moderna | |
| 3 | 2021-12-07 | Janssen/Johnson & Johnson | No |
| 4 | 2022-04-23 | Moderna | No |
| 5 | 2022-12-03 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): low back pain (muscles)
Release 7 — day 14, dose 1
Symptoms: low back pain
Release 8 — day 21, dose 1
Symptoms: Multiple short episodes of dizziness per day, mostly WITHOUT changing vertical position first (!!!), (very odd), mostly while standing or lying down (rarely sitting). I think usually while or shortly after turning? Duration 310 s, frequency 2x8
Release 9 — 3 months, dose 2
Symptoms: Fatigue & weakness; mild nausea; headache; chills onset was 6 to 8 h after eating shellfish & duration was <18 h my COVID-19 sample taken ~26 h after the meal tested negative.
Release 11 — day 28, dose 4
Symptoms: (most likely completely unrelated) 3 or 4 days of bad low-back pain + accompanying moderately severe urinary incontinence resolved with rest; standing & walking or lying flat instead of sitting & slouching; & prescription NSAID
Release 12 — 6 months, dose 4
Symptoms: *covid-19 (with symptoms of sore throat, cough, fatigue, shortness of breath, poor concentration, fever) * lingering shortness of breath * & new attitudinal vertigo/ dizziness (starting 1 or 2 weeks after negative RCT again) which continues now cut off by CDC
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 | Telemedicine | · | · | ✓ |
| SD | Asthenia | ✓ | · | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | · | ✓ |
| SD | Cognitive disorder | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Disturbance in attention | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Impaired work ability | · | · | ✓ |
| SD | Influenza A virus test negative | · | · | ✓ |
| SD | Loss of personal independence in daily activities | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nausea | ✓ | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Urinary incontinence | · | · | ✓ |
| SD | Vertigo | · | · | ✓ |
| SD | Visuospatial deficit | · | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release