4GV-34584-74971
4 vaccinations
5 coded responses
34 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 928 / CA
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-01
Registered in v-safe
-
2021-04-01
Dose 1 — Moderna
- 2021-04-01
-
2021-04-02
Survey response — days 1–6 daily, dose 1MedDRA: Muscle spasms — Feeling: Good · Site: PainFree text: I had a little muscle spasm near my right rib breast are for about 10 minutes last night about 8 hours after injection. Then it went away without issue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-05-01
-
2021-05-05
Dose 2 — Moderna
-
2021-05-06
Survey response — days 1–6 daily, dose 2MedDRA: Diarrhoea — Feeling: Good · Site: PainFree text: I had loose BM about 2 hours after getting immunization and running temp of 99.1.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
- 2021-05-08
- 2021-05-09
- 2021-05-10
- 2021-05-11
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-09
- 2021-06-17
- 2021-08-04
- 2021-11-03
-
2021-11-15
Dose 3 — Moderna
-
2022-04-20
Dose 4 — Moderna
-
2022-04-28
Survey response — day 7, dose 4MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: This was the day after my vaccine was given. The symptoms subsided after a couple of days.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-06-01
-
2022-07-20
Survey response — 3 months, dose 4MedDRA: COVID-19, Cough, Diarrhoea, Oropharyngeal pain, Pain, Upper-airway cough syndrome — Feeling: Good · 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: COVID positive. Coughing, sore throat, post nasal drip, body aches, loose stool.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-20
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-07-21
-
2022-07-21
Call successfulParticipant prefers to complete VAERS report online
- 2022-10-19
-
2023-04-20
Survey response — 12 months, dose 4MedDRA: COVID-19, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-04-20
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-05-05 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): I had a little muscle spasm near my right rib breast are for about 10 minutes last night about 8 hours after injection. Then it went away without issue.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): I had loose BM about 2 hours after getting immunization and running temp of 99.1.
Release 11 — day 7, dose 4
Systemic reaction (other): This was the day after my vaccine was given. The symptoms subsided after a couple of days.
Release 12 — 3 months, dose 4
Symptoms: COVID positive. Coughing, sore throat, post nasal drip, body aches, loose stool.
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 |
|---|---|---|---|---|
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release