4FV-15617-51035
1 vaccination
5 coded responses
8 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 171 / PA
- Registered
- 2021-04-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-04-21
Registered in v-safe
-
2021-04-21
Dose 1 — Moderna
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2021-04-21
Survey response — day 0, dose 1MedDRA: Chest discomfort, Dizziness, Ear pruritus, Throat tightness — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Light headed, throat tightness, chest tightness, itchy earsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-22
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-04-24
- 2021-04-25
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2021-04-28
Survey response — day 7, dose 1MedDRA: Chest discomfort, Dyspnoea — Feeling: Fair · Joint pains, Fatigue or tirednessFree text: Chest tightness shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-05
Survey response — day 14, dose 1MedDRA: Arthralgia, Dyspnoea, Injection site rash, Palpitations, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Shortness of breath and heart palpitations, rash at site of injection, joint pain · Healthcare visit (other): Tried to see doctor but they would not see me in person because of COVID symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-05
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-07-21
Survey response — 3 months, dose 1MedDRA: Arrhythmia, Dyspnoea, Heart rate irregular, Malaise, Throat tightness — Feeling: FairFree text: Vaccination caused me to have shortness of breath, throat tightness, heart arrhythmia and irregular heart it. Was denied medical care by Hershey Medical because of COVID symptoms. Some of these symptoms still linger to this day.MedDRA releases: 2024-11 · check-in free text available
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2021-10-22
Survey response — 6 months, dose 1MedDRA: Chest discomfort, Dizziness, Dyspnoea, Fatigue — Feeling: GoodFree text: Lightheaded, chest heaviness, out of breath, tiredMedDRA releases: 2024-11 · check-in free text available
- 2022-05-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-21 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 7 — day 0, dose 1
Systemic reaction (other): Light headed, throat tightness, chest tightness, itchy ears
Release 8 — day 7, dose 1
Systemic reaction (other): Chest tightness shortness of breath
Release 8 — day 14, dose 1
Symptoms: Shortness of breath and heart palpitations, rash at site of injection, joint pain
Healthcare visit (other): Tried to see doctor but they would not see me in person because of COVID symptoms.
Release 9 — 3 months, dose 1
Symptoms: Vaccination caused me to have shortness of breath, throat tightness, heart arrhythmia and irregular heart it. Was denied medical care by Hershey Medical because of COVID symptoms. Some of these symptoms still linger to this day.
Release 10 — 6 months, dose 1
Symptoms: Lightheaded, chest heaviness, out of breath, tired
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Arrhythmia | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Heart rate irregular | · | · | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Throat tightness | · | · | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Ear pruritus | ✓ | ✓ | ✓ |
| SRO | Throat tightness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release