4EM-22484-63400
2 vaccinations
6 coded responses
13 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 064 / CT
- Registered
- 2021-05-11
- Relationship
- Self
- Race
- Other
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-11
Dose 1 — Moderna
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2021-05-10
Dose 2 — Moderna
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2021-05-11
Registered in v-safe
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2021-05-11
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-05-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-05-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness, NauseaAdult check-in
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2021-05-14
Survey response — days 1–6 daily, dose 2MedDRA: Chest pain, Emergency care — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Severe chest pains, went to ERMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-15
Survey response — days 1–6 daily, dose 2MedDRA: Chest pain — Feeling: Good · Headache, Fatigue or tiredness, NauseaFree text: Mild chest painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-17
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2021-05-24
Survey response — day 14, dose 2MedDRA: Chest pain — Feeling: GoodFree text: Chest pains slowly reduce but then they j creased.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-31
- 2021-06-08
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2021-06-16
Survey response — day 35, dose 2MedDRA: Blood glucose abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Glucose levels have decreased more than usual and sometimes increases but mainly a drop.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-16
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-06-21
Survey response — day 42, dose 2MedDRA: Atrioventricular block, Blood glucose increased, Electrocardiogram abnormal, Heart rate decreased, Heart rate irregular, Office visit — Feeling: Poor · 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: Irregular heart beat, heart rate dropped to 38 which has never happens and new heart block readings in my EKG that my cardiologist has confirmed. Along with usual high glucose and than steep drops of glucose to become hypoglycemic.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-21
Report sent to call center — day 42, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-06-23
- 2021-06-23
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2021-11-08
Survey response — 6 months, dose 2MedDRA: Atrioventricular block, Electrocardiogram abnormal, Pre-existing disease, Viral infection — Feeling: Good · Be unable to work or attend schoolFree text: Had another issue a week ago with my irregular heart on my EKG that showed another heart block, this occurred when my husband caught some virus and I got some of the lighter symptoms. But now it's ok. Doctor don't recommend booster.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-11 | Moderna | |
| 2 | 2021-05-10 | Moderna |
Call center
2 call center cases
2 unsuccessful
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Severe chest pains, went to ER
Systemic reaction (other): Mild chest pain
Release 8 — day 14, dose 2
Symptoms: Chest pains slowly reduce but then they j creased.
Release 9 — day 35, dose 2
Symptoms: Glucose levels have decreased more than usual and sometimes increases but mainly a drop.
Release 9 — day 42, dose 2
Symptoms: Irregular heart beat, heart rate dropped to 38 which has never happens and new heart block readings in my EKG that my cardiologist has confirmed. Along with usual high glucose and than steep drops of glucose to become hypoglycemic.
Release 10 — 6 months, dose 2
Symptoms: Had another issue a week ago with my irregular heart on my EKG that showed another heart block, this occurred when my husband caught some virus and I got some of the lighter symptoms. But now it's ok. Doctor don't recommend booster.
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 | Atrioventricular block | ✓ | ✓ | ✓ |
| SD | Blood glucose abnormal | ✓ | ✓ | ✓ |
| SD | Blood glucose increased | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Electrocardiogram abnormal | ✓ | ✓ | ✓ |
| SD | Heart rate decreased | ✓ | ✓ | ✓ |
| SD | Heart rate irregular | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Emergency care | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release