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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

  1. 2021-04-21
    Registered in v-safe
  2. 2021-04-21
    Dose 1 — Moderna
  3. 2021-04-21
    Survey response — day 0, dose 1
    MedDRA: Chest discomfort, Dizziness, Ear pruritus, Throat tightness — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Free text: Light headed, throat tightness, chest tightness, itchy ears
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness
    Adult check-in
  5. 2021-04-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-04-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache
    Adult check-in
  7. 2021-04-28
    Survey response — day 7, dose 1
    MedDRA: Chest discomfort, Dyspnoea — Feeling: Fair · Joint pains, Fatigue or tiredness
    Free text: Chest tightness shortness of breath
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-05-05
    Survey response — day 14, dose 1
    MedDRA: Arthralgia, Dyspnoea, Injection site rash, Palpitations, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free 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
  9. 2021-05-05
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-07-21
    Survey response — 3 months, dose 1
    MedDRA: Arrhythmia, Dyspnoea, Heart rate irregular, Malaise, Throat tightness — Feeling: Fair
    Free 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
  11. 2021-10-22
    Survey response — 6 months, dose 1
    MedDRA: Chest discomfort, Dizziness, Dyspnoea, Fatigue — Feeling: Good
    Free text: Lightheaded, chest heaviness, out of breath, tired
    MedDRA releases: 2024-11 · check-in free text available
  12. 2022-05-05

Vaccinations

DoseDateManufacturerCo-administered
12021-04-21Moderna

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — day 0, dose 1

2021-04-21

Systemic reaction (other): Light headed, throat tightness, chest tightness, itchy ears

Release 8 — day 7, dose 1

2021-04-28

Systemic reaction (other): Chest tightness shortness of breath

Release 8 — day 14, dose 1

2021-05-05

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

2021-07-21

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

2021-10-22

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event ✓ ✓ ✓
SDArrhythmia · · ✓
SDArthralgia ✓ ✓ ✓
SDChest discomfort · · ✓
SDDizziness · · ✓
SDDyspnoea ✓ ✓ ✓
SDFatigue · · ✓
SDHeart rate irregular · · ✓
SDInjection site rash ✓ ✓ ✓
SDMalaise · · ✓
SDPalpitations ✓ ✓ ✓
SDThroat tightness · · ✓
SROChest discomfort ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROEar pruritus ✓ ✓ ✓
SROThroat tightness ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release