4JX-15135-56958
3 vaccinations
11 coded responses
29 check-ins
11 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 254 / WV
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Dose 1 — Moderna
-
2021-01-28
Registered in v-safe
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2021-01-28
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tirednessAdult check-in
- 2021-01-30
-
2021-02-06
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pruritus, Vaccination site swelling — Feeling: FairFree text: Redness, itching & slight swelling near vaccination site upper left arm on 1/31-2/2MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
- 2021-02-23
-
2021-02-26
Dose 2 — Moderna
-
2021-02-26
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Hyperacusis, Photophobia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: light & noise sensitivityMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Muscular weakness, Night sweats, Oropharyngeal pain — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: Night Sweating, Muscle Weakness, Sore ThroatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-03-12
- 2021-03-19
- 2021-03-26
-
2021-04-04
Survey response — day 35, dose 2MedDRA: Condition aggravated, Cough, Fatigue, Headache, Myalgia, Pre-existing disease, Pyrexia, SARS-CoV-2 test — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professionalFree text: Symptoms: low-grade fever; worse than usual: fatigue, headache & cough; some additional muscle aches · Healthcare visit (other): COVID testMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Report sent to call center — day 35, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-12
- 2021-05-30
- 2021-06-15
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2021-08-27
Survey response — 6 months, dose 2MedDRA: Brain fog, Fatigue, Pre-existing disease, Throat irritation — Feeling: Poor · 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: Worsening of fatigue, brain fog and airway irritation.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-27
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)
-
2021-08-31
Call successfulCompleted over the phone
- 2022-02-26
-
2022-06-21
Dose 3 — Moderna
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2022-06-24
Survey response — days 1–6 daily, dose 3MedDRA: Insomnia, Migraine, Urinary incontinence — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Migraine, insomnia, bladder leakageMedDRA releases: 2024-11 · check-in free text available
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2022-06-25
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Migraine, Muscle twitching, Urinary incontinence — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Cough, migraine, bladder leakage, twitchesMedDRA releases: 2024-11 · check-in free text available
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2022-06-27
Survey response — days 1–6 daily, dose 3MedDRA: Insomnia, Malaise — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: General malaise, insomniaMedDRA releases: 2024-11 · check-in free text available
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2022-06-28
Survey response — day 7, dose 3MedDRA: Bladder disorder, Cough, Oropharyngeal pain — Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Cough, sore throat, bladder issuesMedDRA releases: 2024-11 · check-in free text available
- 2022-07-05
- 2022-07-12
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2022-07-19
Survey response — day 28, dose 3MedDRA: Muscle contracture, Nervous system disorder, Sleep disorder, Tremor — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Nerve issues (sort of like a tremor or contraction) that disturb my sleep. This has fluctuated in intensity and is worse again this weekMedDRA releases: 2024-11 · check-in free text available
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2022-07-19
Report sent to call center — day 28, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-07-20
- 2022-07-20
- 2022-07-20
- 2022-07-28
- 2022-08-02
- 2022-09-20
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2022-12-20
Survey response — 6 months, dose 3MedDRA: Back pain, Nervous system disorder, Pre-existing disease, Productive cough — Feeling: Poor · 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: Chronic cough has become phlegmy. More back pain. Ongoing nerve issues.MedDRA releases: 2024-11 · check-in free text available
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2022-12-20
Report sent to call center — 6 months, dose 3Be 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)
- 2022-12-21
- 2022-12-21
- 2023-06-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2022-06-21 | Moderna | No |
Call center
4 call center cases
2 successful · 2 unsuccessful
VAERS report filed, before or during a call: 2
1 wait over 3 months for a first call
Free text
Release 3 — day 14, dose 1
Symptoms: Redness, itching & slight swelling near vaccination site upper left arm on 1/31-2/2
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): light & noise sensitivity
Systemic reaction (other): Night Sweating, Muscle Weakness, Sore Throat
Release 6 — day 35, dose 2
Symptoms: low-grade fever; worse than usual: fatigue, headache & cough; some additional muscle aches
Healthcare visit (other): COVID test
Release 9 — 6 months, dose 2
Symptoms: Worsening of fatigue, brain fog and airway irritation.
Release 12 — days 1–6 daily, dose 3
Systemic reaction (other): Migraine, insomnia, bladder leakage
Systemic reaction (other): Cough, migraine, bladder leakage, twitches
Systemic reaction (other): General malaise, insomnia
Release 12 — day 7, dose 3
Systemic reaction (other): Cough, sore throat, bladder issues
Release 12 — day 28, dose 3
Symptoms: Nerve issues (sort of like a tremor or contraction) that disturb my sleep. This has fluctuated in intensity and is worse again this week
Release 12 — 6 months, dose 3
Symptoms: Chronic cough has become phlegmy. More back pain. Ongoing nerve issues.
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 | SARS-CoV-2 test | ✓ | ✓ | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Brain fog | ✓ | · | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Muscle contracture | · | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Nervous system disorder | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Sleep disorder | · | · | ✓ |
| SD | Throat irritation | ✓ | · | ✓ |
| SD | Tremor | · | · | ✓ |
| SD | Vaccination site swelling | ✓ | ✓ | ✓ |
| SRO | Bladder disorder | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Hyperacusis | ✓ | ✓ | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Malaise | · | · | ✓ |
| SRO | Migraine | · | · | ✓ |
| SRO | Muscle twitching | · | · | ✓ |
| SRO | Muscular weakness | ✓ | ✓ | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Photophobia | ✓ | ✓ | ✓ |
| SRO | Urinary incontinence | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release