4FB-18936-26404
4 vaccinations
10 coded responses
54 check-ins
10 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 211 / MD
- Registered
- 2021-02-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-26
Registered in v-safe
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2021-02-26
Dose 1 — Moderna
- 2021-02-26
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2021-02-27
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Chills, Fatigue or tirednessAdult check-in
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2021-02-28
Survey response — days 1–6 daily, dose 1MedDRA: Anxiety, Depression, Feeling of despair — Feeling: GoodFree text: I did not report this yesterday: I experienced extreme depression in the morning which lifted by mid to late afternoon. I had a feeling of hopelessness and impending doom that was as disconcerting as it was upsetting since I have never experienced anything like it. I didnt report it yesterday since the focus is on physical symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Headache, Fatigue or tirednessAdult check-in
- 2021-03-02
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2021-03-03
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
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2021-03-26
Dose 2 — Moderna
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2021-03-26
Health check-in — day 0, dose 2Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-27
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-09
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2021-04-16
Survey response — day 21, dose 2MedDRA: Chest pain, Dizziness, Fatigue — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Fatigue, chest pain, dizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
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2021-04-30
Survey response — day 35, dose 2MedDRA: Dizziness, Dyspnoea, Fatigue, Palpitations — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Palpitations, shortness of breath, dizziness, fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
- 2021-06-25
- 2021-09-24
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2021-10-29
Dose 3 — Moderna
- 2021-10-29
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-11-01
- 2021-11-02
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2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-06
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2021-11-12
Survey response — day 14, dose 3MedDRA: Chest pain, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Headache, chest pain, fatigueMedDRA releases: 2024-11 · check-in free text available
- 2021-11-19
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2021-11-26
Survey response — day 28, dose 3MedDRA: Chest pain, Cough, Fatigue, Headache — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Chest pain, cough, headache, fatigueMedDRA releases: 2024-11 · check-in free text available
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2021-12-04
Survey response — day 35, dose 3MedDRA: Fatigue, Headache, Pyrexia — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Headache, low fever, fatigueMedDRA releases: 2024-11 · check-in free text available
- 2021-12-10
- 2022-01-28
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2022-04-21
Dose 4 — Moderna
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2022-04-21
Health check-in — day 0, dose 4Feeling: Fair · Site: Pain · Chills, Muscle or body achesAdult check-in
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2022-04-22
Survey response — days 1–6 daily, dose 4MedDRA: Chest pain, Cough, Lymphadenopathy, Muscle spasms, Neck pain, Oropharyngeal pain — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Chest pain, leg cramps, dry cough, neck pain, sore throat like from swollen glandsMedDRA releases: 2024-11 · check-in free text available
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2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-04-24
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-04-25
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-04-26
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-04-27
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-04-28
Health check-in — day 7, dose 4Feeling: Poor · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-05-05
Survey response — day 14, dose 4MedDRA: Dyspnoea, Fatigue — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Increased fatigue, shortness of breathMedDRA releases: 2024-11 · check-in free text available
- 2022-05-12
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2022-05-19
Survey response — day 28, dose 4MedDRA: Fatigue, Headache, Neck pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Fever, headache, neck ache, fatigueMedDRA releases: 2024-11 · check-in free text available
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2022-05-26
Survey response — day 35, dose 4MedDRA: Chills, Dyspnoea, Fatigue, Office visit, Pain, Palpitations, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Body aches, chills, fever, heart palpitations, shortness of breath, fatigue · Healthcare visit (other): In office visitMedDRA releases: 2024-11 · check-in free text available
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2022-05-26
Report sent to call center — day 35, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-05-27
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2022-05-27
Call successfulCompleted over the phone
- 2022-06-02
- 2022-07-22
- 2023-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-26 | Moderna | |
| 2 | 2021-03-26 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-04-21 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): I did not report this yesterday: I experienced extreme depression in the morning which lifted by mid to late afternoon. I had a feeling of hopelessness and impending doom that was as disconcerting as it was upsetting since I have never experienced anything like it. I didnt report it yesterday since the focus is on physical symptoms
Release 7 — day 21, dose 2
Symptoms: Fatigue, chest pain, dizziness
Release 8 — day 35, dose 2
Symptoms: Palpitations, shortness of breath, dizziness, fatigue
Release 10 — day 14, dose 3
Symptoms: Headache, chest pain, fatigue
Release 10 — day 28, dose 3
Symptoms: Chest pain, cough, headache, fatigue
Release 10 — day 35, dose 3
Symptoms: Headache, low fever, fatigue
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Chest pain, leg cramps, dry cough, neck pain, sore throat like from swollen glands
Release 11 — day 14, dose 4
Symptoms: Increased fatigue, shortness of breath
Release 11 — day 28, dose 4
Symptoms: Fever, headache, neck ache, fatigue
Release 11 — day 35, dose 4
Symptoms: Body aches, chills, fever, heart palpitations, shortness of breath, fatigue
Healthcare visit (other): In office visit
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 | Chest pain | ✓ | ✓ | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Chest pain | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Depression | ✓ | ✓ | ✓ |
| SRO | Feeling of despair | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Muscle spasms | · | · | ✓ |
| SRO | Neck pain | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release