4KL-24872-64932
2 vaccinations
3 coded responses
24 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 240 / VA
- Registered
- 2021-05-31
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-31
Registered in v-safe
-
2021-05-31
Dose 1 — Moderna
- 2021-05-31
- 2021-06-01
- 2021-06-02
- 2021-06-03
- 2021-06-04
- 2021-06-05
- 2021-06-06
- 2021-06-07
-
2021-06-14
Survey response — day 14, dose 1MedDRA: Headache, Heart rate irregular — Feeling: GoodFree text: Irregular pulse and intermittent headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-21
-
2021-06-28
Dose 2 — Moderna
- 2021-06-28
-
2021-06-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-06-30
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling · Fatigue or tirednessAdult check-in
-
2021-07-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-07-02
-
2021-07-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
- 2021-07-04
-
2021-07-06
Health check-in — day 7, dose 2Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-07-12
Survey response — day 14, dose 2MedDRA: Dyspepsia, Emergency care, Heart rate irregular, Hypertension — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: High BP 189 / 109 with irregular pulse and heart burn. I also have a CPAP recall I am going through. I went to the ER and had my blood drawn an am fine as I was told by the ER doctor. After all that I am not going to the ER again in a very long time.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-12
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-19
- 2021-07-21
-
2021-07-22
Call successfulDoes not wish to fill out VAERS report
- 2021-07-26
- 2021-08-04
-
2021-08-11
Survey response — day 42, dose 2MedDRA: Brain fog, Constipation, Dyspepsia, Psychiatric symptom, Sleep disorder — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Heart Burn and constipation worst some days more than others, I feel alone and that I am suppose to wake up 3 am to go to the bathroom. I am always in a fog and have to live with this for I should be well physically but do not think so.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-09-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-31 | Moderna | |
| 2 | 2021-06-28 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 9 — day 14, dose 1
Symptoms: Irregular pulse and intermittent headache.
Release 9 — day 14, dose 2
Symptoms: High BP 189 / 109 with irregular pulse and heart burn. I also have a CPAP recall I am going through. I went to the ER and had my blood drawn an am fine as I was told by the ER doctor. After all that I am not going to the ER again in a very long time. cut off by CDC
Release 9 — day 42, dose 2
Symptoms: Heart Burn and constipation worst some days more than others, I feel alone and that I am suppose to wake up 3 am to go to the bathroom. I am always in a fog and have to live with this for I should be well physically but do not think so.
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 | Brain fog | ✓ | · | ✓ |
| SD | Constipation | ✓ | · | ✓ |
| SD | Dyspepsia | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Heart rate irregular | ✓ | ✓ | ✓ |
| SD | Hypertension | ✓ | ✓ | ✓ |
| SD | Psychiatric symptom | ✓ | · | ✓ |
| SD | Sleep disorder | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release