4EQ-83786-21411
4 vaccinations
11 coded responses
55 check-ins
10 free-text entries
7 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 220 / VA
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
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2021-01-27
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Fever · NoneAdult check-in
- 2021-01-28
- 2021-01-30
- 2021-02-09
- 2021-02-13
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2021-02-20
Dose 2 — Moderna
- 2021-02-20
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2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Pain, SwellingFree text: Mild swelling and mild pain in lower gland of left jaw/neck. None on other side.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Ear swelling, Flashback — Feeling: Good · Site: Pain · Be unable to workFree text: Around noon I had a series of flashbacks of experiences that lasted only several minutes. I could not determine if they were from recent dreams or reality or something I read about. It stopped within an hour. This has never happened before but was like coming out of sleep after surgery. Felt like my ears inside were swollen like ate too much salt or had allergic reaction to something.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-23
- 2021-02-24
- 2021-02-25
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2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Dyspnoea — Feeling: Good · Fatigue or tiredness · 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: Shortness of breath when carrying 24 lb. grandsonMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-26
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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2021-02-27
Survey response — day 7, dose 2MedDRA: Dyspnoea — Feeling: Good · Fatigue or tirednessFree text: Mild shortness of breath when climbing stairs in my home.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
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2021-04-03
Survey response — day 42, dose 2MedDRA: Balance disorder, Deafness, Dyspnoea, Ear discomfort, Eye swelling, Wheezing — Feeling: Good · Be unable to do your normal daily activitiesFree text: Some balance issues and some shortness of breath and wheezing plus swelling around my eyes and mild loss of hearing. My ears feel swollen or clogged inside. It could be the high pollen county now or the insect spray applied in and outside the houseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-22
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2021-08-24
Survey response — 6 months, dose 2MedDRA: Bronchitis, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion — 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: I got a bad cold w sore throat and head congestion. No fever. Caught it from child 27 mos. old who. He tested neg. fir Covid on 2 tests. I got bronchitis and put on two antibiotics. Totally well now.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-24
Report sent to call center — 6 months, 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)
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2021-08-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2021-08-25
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2021-10-31
Dose 3 — Moderna
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-14
- 2021-11-21
- 2021-11-28
- 2021-12-05
- 2021-12-12
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2022-01-30
Survey response — 3 months, dose 3MedDRA: Asthenia, Balance disorder, Disturbance in attention, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Some poor balance when standing (not dizziness), hard to concentrate, some weakness when standing from sitting position or carrying groceries. · Healthcare visit (other): Will do in person PCP visit tomorrow.MedDRA releases: 2024-11 · check-in free text available
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2022-01-30
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-02-03
- 2022-02-07
- 2022-02-09
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2022-05-01
Dose 4 — Pfizer-BioNTech
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2022-05-01
Survey response — 6 months, dose 3MedDRA: Asthma, Atelectasis, Chest X-ray abnormal, Chills, Cough, Influenza A virus test negative, Influenza B virus test negative, Office visit, Pyrexia, SARS-CoV-2 test negative — 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 · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Have a bad cough that turned into chills and fever Friday night. Went to (b)(6) Urgent Care in morning. Tests neg for A and for B flu and both Covid test showed neg. Chest x-Rays showed no pneumonia but subsegmentalatelectasis in R Lower lung. · Healthcare visit (other): My pulmonologist I see for asthma.MedDRA releases: 2024-11 · check-in free text available
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2022-05-01
Survey response — day 0, dose 4MedDRA: Chills, Pre-existing disease, Pyrexia — Feeling: Poor · Fever · 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: Had chills and fever Night of April 29. But got shot on 4/25. I have a bad cold w cough that started 4/23.MedDRA releases: 2024-11 · check-in free text available
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2022-05-01
Report sent to call center — day 0, 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)
-
2022-05-01
Report sent to call center — 6 months, dose 3Be 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)
- 2022-05-02
-
2022-05-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-08
- 2022-05-15
- 2022-05-22
- 2022-05-31
- 2022-06-06
- 2022-06-12
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2022-07-31
Survey response — 3 months, dose 4MedDRA: Influenza virus test, Pneumonia, Pre-existing disease, SARS-CoV-2 test negative, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sinus infection from summer allergyDoctor prescribed antibiotic for 10 days to prevent it causing exacerbation of my asthma. Chest X-ray neg. For pneumonia. Flu test and Both Covid test results neg. Almost no symptoms left now at 8 days on the Med.MedDRA releases: 2024-11 · check-in free text available
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2022-07-31
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-08-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-30
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2023-05-01
Survey response — 12 months, dose 4MedDRA: Deafness, Nasopharyngitis, Office visit, Sinusitis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-05-01
Report sent to call center — 12 months, dose 4Be 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)
- 2023-05-02
- 2023-05-03
-
2023-05-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-10-31 | Moderna | No |
| 4 | 2022-05-01 | Pfizer-BioNTech | No |
Call center
7 call center cases
7 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Mild swelling and mild pain in lower gland of left jaw/neck. None on other side.
Systemic reaction (other): Around noon I had a series of flashbacks of experiences that lasted only several minutes. I could not determine if they were from recent dreams or reality or something I read about. It stopped within an hour. This has never happened before but was like coming out of sleep after surgery. Felt like my ears inside were swollen like ate too much salt or had allergic reaction to something.
Systemic reaction (other): Shortness of breath when carrying 24 lb. grandson
Release 4 — day 7, dose 2
Systemic reaction (other): Mild shortness of breath when climbing stairs in my home.
Release 6 — day 42, dose 2
Symptoms: Some balance issues and some shortness of breath and wheezing plus swelling around my eyes and mild loss of hearing. My ears feel swollen or clogged inside. It could be the high pollen county now or the insect spray applied in and outside the house cut off by CDC
Release 9 — 6 months, dose 2
Symptoms: I got a bad cold w sore throat and head congestion. No fever. Caught it from child 27 mos. old who. He tested neg. fir Covid on 2 tests. I got bronchitis and put on two antibiotics. Totally well now.
Release 11 — 3 months, dose 3
Symptoms: Some poor balance when standing (not dizziness), hard to concentrate, some weakness when standing from sitting position or carrying groceries.
Healthcare visit (other): Will do in person PCP visit tomorrow.
Release 11 — 6 months, dose 3
Symptoms: Have a bad cough that turned into chills and fever Friday night. Went to (b)(6) Urgent Care in morning. Tests neg for A and for B flu and both Covid test showed neg. Chest x-Rays showed no pneumonia but subsegmentalatelectasis in R Lower lung.
Healthcare visit (other): My pulmonologist I see for asthma.
redacted (b)(6)
Release 11 — day 0, dose 4
Systemic reaction (other): Had chills and fever Night of April 29. But got shot on 4/25. I have a bad cold w cough that started 4/23.
Release 12 — 3 months, dose 4
Symptoms: Sinus infection from summer allergyDoctor prescribed antibiotic for 10 days to prevent it causing exacerbation of my asthma. Chest X-ray neg. For pneumonia. Flu test and Both Covid test results neg. Almost no symptoms left now at 8 days on the Med. 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 | Asthma | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Atelectasis | · | · | ✓ |
| SD | Balance disorder | ✓ | ✓ | ✓ |
| SD | Bronchitis | ✓ | · | ✓ |
| SD | Chest X-ray abnormal | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Deafness | ✓ | ✓ | ✓ |
| SD | Disturbance in attention | · | · | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Ear discomfort | ✓ | ✓ | ✓ |
| SD | Eye swelling | ✓ | ✓ | ✓ |
| SD | Influenza A virus test negative | · | · | ✓ |
| SD | Influenza B virus test negative | · | · | ✓ |
| SD | Influenza virus test | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Wheezing | ✓ | ✓ | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Ear swelling | ✓ | ✓ | ✓ |
| SRO | Flashback | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release