4BS-21222-57956
3 vaccinations
4 coded responses
12 check-ins
4 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 442 / OH
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Dose 1 — Moderna
-
2021-01-18
Registered in v-safe
-
2021-01-18
Survey response — day 7, dose 1MedDRA: Adverse reaction, Dyspnoea, Emergency care, Headache, Unevaluable event — Feeling: Fair · Site: Pain · Headache · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Systemic reaction (other): Shortness of breath since 1/12/21. Bad headache 1/12/13 - 1/13/21. Went to ER for SOB 1/14/21. · Healthcare visit (other): Again, these symptoms were LAST WEEK, not today. The weeks of 1/11/21.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-18
Report sent to call center — day 7, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-19
- 2021-01-28
-
2021-02-05
Dose 2 — Moderna
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Abdominal painAdult check-in
-
2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Dyspnoea — Feeling: Poor · Site: Redness, Swelling, Itching · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: VERY SHORT OF BREATH SINCE FIRST VACCINE!!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-10
Report sent to call center — days 1–6 daily, 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)
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Dyspnoea, Fibrin D dimer increased — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Systemic reaction (other): Short of breath since first shot Jan 5. Extremely high D-dimer (over 8000) since first shot. Today I had to have an ultrasound of my legs and CT of abdomen due to d-diimer · Healthcare visit (other): CT of abdomen and ultrasound of legs due to extremely high d-dimer level since first vaccine Jan 5MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-12
Survey response — day 7, dose 2MedDRA: Dyspnoea — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tirednessFree text: SHORT OF BREATH SINCE FIRST VACCINEMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-03-22
-
2021-07-17
Call successfulParticipant prefers to complete VAERS report online
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2021-10-22
Dose 3 — Moderna
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2021-10-25
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
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2021-10-25
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Swelling, Itching · NoneAdult check-in
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Swelling, Itching · NoneAdult check-in
- 2021-10-28
- 2021-11-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-05 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
Call center
4 call center cases
2 successful · 2 unsuccessful
Free text
Release 2 — day 7, dose 1
Systemic reaction (other): Shortness of breath since 1/12/21. Bad headache 1/12/13 - 1/13/21. Went to ER for SOB 1/14/21.
Healthcare visit (other): Again, these symptoms were LAST WEEK, not today. The weeks of 1/11/21.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): VERY SHORT OF BREATH SINCE FIRST VACCINE!!
Systemic reaction (other): Short of breath since first shot Jan 5. Extremely high D-dimer (over 8000) since first shot. Today I had to have an ultrasound of my legs and CT of abdomen due to d-diimer
Healthcare visit (other): CT of abdomen and ultrasound of legs due to extremely high d-dimer level since first vaccine Jan 5
Release 4 — day 7, dose 2
Systemic reaction (other): SHORT OF BREATH SINCE FIRST VACCINE
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 | Adverse reaction | ✓ | · | ✓ |
| HCVO | Emergency care | ○ | ✓ | ○ |
| HCVO | Fibrin D dimer increased | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ○ | ✓ | ○ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Emergency care | ✓ | ✓ | ✓ |
| SRO | Fibrin D dimer increased | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release