4LK-32250-10152
4 vaccinations
11 coded responses
21 check-ins
11 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 902 / CA
- Registered
- 2021-03-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Dose 1 — Moderna
-
2021-03-01
Registered in v-safe
- 2021-03-01
-
2021-03-05
Dose 2 — Moderna
- 2021-03-05
-
2021-03-06
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Site: Pain, SwellingFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: ItchingFree text: I walked two miles in 44 minutes. Feeling great.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-08
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-09
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-10
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-11
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Survey response — day 7, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-18
- 2021-09-05
-
2021-12-21
Dose 3 — Moderna
- 2022-03-05
-
2022-04-21
Dose 4 — Moderna
-
2022-05-14
Survey response — day 21, dose 4MedDRA: Asthenia, Cerebrovascular accident, Dyspnoea, Hospitalisation, Magnetic resonance imaging head abnormal, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Within a few hours of receiving the vaccine I felt out of breath with no energy! 10 days later I went to doctor and then to hospital where an MRI results showed that I had had a stroke in the brain. I weigh 107 lbs. I was a very healthy person. NoMedDRA releases: 2024-11 · check-in free text available
-
2022-05-14
Report sent to call center — day 21, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-05-17
-
2022-05-18
Call successfulCompleted over the phone
-
2022-05-26
Survey response — day 35, dose 4MedDRA: Cerebrovascular accident, Malaise — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: I have filed the information with someone that called me as I was sick after my booster and had a stroke. I am a very healthy person with no issues to cause a stroke.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-26
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-05-27
-
2022-06-02
Survey response — day 42, dose 4MedDRA: Cerebrovascular accident, Emergency care, Feeling abnormal, Magnetic resonance imaging head abnormal, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: After getting the booster I felt awful and after 8 days I went to urgent care, then sent to hospital to get MRI which showed I had had a stroke. I was physically fit with no health issues that would indicate possibility of a struck.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-02
Report sent to call center — day 42, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-06-03
- 2022-06-03
- 2022-06-03
-
2022-06-09
Call successfulReported to VAERS during previous contact from GDIT
-
2022-06-09
Call successfulReported to VAERS during previous contact from GDIT
-
2022-07-22
Survey response — 3 months, dose 4MedDRA: Cerebrovascular accident, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: After my second booster shot, I had a stroke. It was given the first day I was eligible and I only weigh 104 lbs. within two hours, I felt like I did when I had covid. I think it might be a good idea to check people weight. I am still recovering.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-22
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-07-26
- 2022-07-26
- 2022-07-26
- 2022-07-26
-
2022-08-03
Call successfulDoes not wish to fill out VAERS report
- 2022-10-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | |
| 2 | 2021-03-05 | Moderna | |
| 3 | 2021-12-21 | Moderna | No |
| 4 | 2022-04-21 | Moderna | No |
Call center
4 call center cases
4 successful
VAERS report filed, before or during a call: 3
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): No
Systemic reaction (other): I walked two miles in 44 minutes. Feeling great.
Systemic reaction (other): No
Systemic reaction (other): None
Systemic reaction (other): No
Systemic reaction (other): None
Release 5 — day 7, dose 2
Systemic reaction (other): None
Release 11 — day 21, dose 4
Symptoms: Within a few hours of receiving the vaccine I felt out of breath with no energy! 10 days later I went to doctor and then to hospital where an MRI results showed that I had had a stroke in the brain. I weigh 107 lbs. I was a very healthy person. No cut off by CDC
Release 11 — day 35, dose 4
Symptoms: I have filed the information with someone that called me as I was sick after my booster and had a stroke. I am a very healthy person with no issues to cause a stroke.
Release 11 — day 42, dose 4
Symptoms: After getting the booster I felt awful and after 8 days I went to urgent care, then sent to hospital to get MRI which showed I had had a stroke. I was physically fit with no health issues that would indicate possibility of a struck.
Release 12 — 3 months, dose 4
Symptoms: After my second booster shot, I had a stroke. It was given the first day I was eligible and I only weigh 104 lbs. within two hours, I felt like I did when I had covid. I think it might be a good idea to check people weight. I am still recovering. cut off by CDC
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 | Asthenia | · | · | ✓ |
| SD | Cerebrovascular accident | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Feeling abnormal | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Magnetic resonance imaging head abnormal | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release