4PB-88884-13976
3 vaccinations
4 coded responses
27 check-ins
4 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 856 / AZ
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Registered in v-safe
-
2021-03-17
Dose 1 — Moderna
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-31
- 2021-04-07
-
2021-04-14
Dose 2 — Moderna
- 2021-04-14
-
2021-04-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-16
- 2021-04-17
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
-
2021-07-14
Survey response — 3 months, dose 2MedDRA: Cardiac failure, End stage renal disease, Office visit, Pre-existing disease, Renal failure — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Kidney failure and systemic heart failure. Have had chronic kidney disease for many many years but a quick decline started in April and now end stage · Healthcare visit (other): Appointments with nephrology and cardiologyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-14
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-26
-
2021-10-13
Survey response — 6 months, dose 2MedDRA: Cardiac disorder, Renal failure — 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 visitFree text: Kidney failure and heart diseaseMedDRA releases: 2024-11 · check-in free text available
-
2021-10-13
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-15
-
2021-11-17
Dose 3 — Moderna
-
2022-04-14
Survey response — 12 months, dose 2MedDRA: Ejection fraction decreased, Left ventricular failure — 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 visitFree text: Systolic heart failure with low ejection fractionMedDRA releases: 2024-11 · check-in free text available
-
2022-04-14
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-19
- 2022-05-18
-
2022-11-17
Survey response — 12 months, dose 3MedDRA: Acute kidney injury, COVID-19, Cardiac failure congestive, Cough, 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 visitFree text: Symptoms: Continued cough, acute CKD and congestive heart failure since 2nd vaccine . Now improving/stable but newly Covid positive for first time · Healthcare visit (other): Nephrologist + CardiologistMedDRA releases: 2024-11 · check-in free text available
-
2022-11-17
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-18
- 2022-11-18
- 2022-11-18
- 2022-11-18
-
2022-11-18
Call successfulCompleted over the phone
-
2022-11-18
Call successfulCompleted over the phone
-
2022-11-18
Call successfulCompleted over the phone
-
2022-11-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-14 | Moderna | |
| 3 | 2021-11-17 | Moderna | No |
Call center
4 call center cases
4 successful
VAERS report filed, before or during a call: 3
Free text
Release 9 — 3 months, dose 2
Symptoms: Kidney failure and systemic heart failure. Have had chronic kidney disease for many many years but a quick decline started in April and now end stage
Healthcare visit (other): Appointments with nephrology and cardiology
Release 10 — 6 months, dose 2
Symptoms: Kidney failure and heart disease
Release 11 — 12 months, dose 2
Symptoms: Systolic heart failure with low ejection fraction
Release 12 — 12 months, dose 3
Symptoms: Continued cough, acute CKD and congestive heart failure since 2nd vaccine . Now improving/stable but newly Covid positive for first time
Healthcare visit (other): Nephrologist + Cardiologist
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Acute kidney injury | · | · | ✓ |
| SD | Cardiac disorder | · | · | ✓ |
| SD | Cardiac failure | ✓ | ✓ | ✓ |
| SD | Cardiac failure congestive | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ejection fraction decreased | · | · | ✓ |
| SD | End stage renal disease | ✓ | · | ✓ |
| SD | Left ventricular failure | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Renal failure | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release