4FT-41154-28357
5 vaccinations
8 coded responses
51 check-ins
8 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 995 / AK
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-18
Registered in v-safe
-
2021-01-18
Dose 1 — Moderna
- 2021-01-18
- 2021-01-19
-
2021-01-20
Survey response — days 1–6 daily, dose 1MedDRA: Epistaxis, Lacrimation increased — Feeling: GoodFree text: 1. I experienced tearing eyes, an allergic reaction typical for me when I encounter allergens. 2. I experienced a bloody nose, which is not a common occurrence for me. This nosebleed was very difficult to stanch; it lasted over 25 minutes before stopping.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-02-01
- 2021-02-08
-
2021-02-15
Dose 2 — Moderna
- 2021-02-15
-
2021-02-16
Survey response — days 1–6 daily, dose 2MedDRA: Peripheral coldness — Feeling: Good · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Cold handsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-03-01
- 2021-03-08
-
2021-03-15
Survey response — day 28, dose 2MedDRA: Macular oedema — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Macular swelling, right eye. · Healthcare visit (other): At a scheduled follow-up appointment with my retinal specialist, examination found increased swelling of macula, which had previously been in general decline.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-22
- 2021-03-29
- 2021-05-17
-
2021-08-16
Survey response — 6 months, dose 2MedDRA: Electrolyte imbalance, Emergency care, Fatigue, Gait inability, Hyponatraemia, Muscular weakness, Office visit, Palpitations, Renal failure — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Two trips to the emergency room; heart palpitations, muscle weakness, extreme fatigue, inability to walk. Diagnosed hyponatremia and imbalanced electrolytes, renal insuffiency; treated at hospital with saline. Followup dir for at home & dr office.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-16
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-19
- 2021-08-20
- 2021-08-24
-
2021-08-24
Call successfulParticipant prefers to complete VAERS report online
-
2021-11-10
Dose 3 — Moderna
-
2022-02-15
Survey response — 12 months, dose 2MedDRA: Hypertension, Pre-existing disease, Renal failure — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Very high blood pressure, which is not responding well to the Rx; appt has been set with my medical care professional. Renal insufficiency; I am being referred to a nephrologist.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-15
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-02-16
-
2022-02-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-05-09
Dose 4 — Moderna
- 2022-05-09
-
2022-05-10
Survey response — days 1–6 daily, dose 4MedDRA: Decreased appetite — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesFree text: No appetite.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-11
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Joint pains, Muscle or body achesAdult check-in
-
2022-05-12
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-05-13
- 2022-05-14
- 2022-05-16
- 2022-05-23
-
2022-05-30
Survey response — day 21, dose 4MedDRA: Muscular weakness — Feeling: GoodFree text: Muscle weakness in thighs and gluteus.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-06
- 2022-06-13
- 2022-06-20
- 2022-08-08
-
2022-09-28
Dose 5 — Moderna
-
2022-10-01
Survey response — days 1–6 daily, dose 5MedDRA: Chills, Fatigue, Hypersomnia, Musculoskeletal stiffness, Myalgia, Sleep disorder — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: The FIRST night, I experienced severe chills which prevented me from sleeping. The next day, my muscles were painful & stiff; I was exhausted; I slept 18 hours.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-02
Health check-in — days 1–6 daily, dose 5Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-10-03
Health check-in — days 1–6 daily, dose 5Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-04
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-11-09
- 2022-12-28
- 2023-03-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-18 | Moderna | |
| 2 | 2021-02-15 | Moderna | |
| 3 | 2021-11-10 | Moderna | No |
| 4 | 2022-05-09 | Moderna | No |
| 5 | 2022-09-28 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): 1. I experienced tearing eyes, an allergic reaction typical for me when I encounter allergens. 2. I experienced a bloody nose, which is not a common occurrence for me. This nosebleed was very difficult to stanch; it lasted over 25 minutes before stopping.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Cold hands
Release 5 — day 28, dose 2
Symptoms: Macular swelling, right eye.
Healthcare visit (other): At a scheduled follow-up appointment with my retinal specialist, examination found increased swelling of macula, which had previously been in general decline.
Release 9 — 6 months, dose 2
Symptoms: Two trips to the emergency room; heart palpitations, muscle weakness, extreme fatigue, inability to walk. Diagnosed hyponatremia and imbalanced electrolytes, renal insuffiency; treated at hospital with saline. Followup dir for at home & dr office. cut off by CDC
Release 11 — 12 months, dose 2
Symptoms: Very high blood pressure, which is not responding well to the Rx; appt has been set with my medical care professional. Renal insufficiency; I am being referred to a nephrologist.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): No appetite.
Release 11 — day 21, dose 4
Symptoms: Muscle weakness in thighs and gluteus.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): The FIRST night, I experienced severe chills which prevented me from sleeping. The next day, my muscles were painful & stiff; I was exhausted; I slept 18 hours.
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 | Macular oedema | ✓ | ✓ | ✓ |
| SD | Electrolyte imbalance | ✓ | · | ✓ |
| SD | Emergency care | ✓ | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Gait inability | ✓ | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Hyponatraemia | ✓ | · | ✓ |
| SD | Macular oedema | ✓ | ✓ | ✓ |
| SD | Muscular weakness | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Palpitations | ✓ | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Renal failure | ✓ | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Decreased appetite | · | · | ✓ |
| SRO | Epistaxis | ✓ | ✓ | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Hypersomnia | · | · | ✓ |
| SRO | Lacrimation increased | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Peripheral coldness | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release