4QM-10948-62851
2 vaccinations
6 coded responses
7 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 212 / MD
- Registered
- 2021-04-18
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-17
Dose 1 — Moderna
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2021-04-18
Registered in v-safe
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2021-04-19
Survey response — days 1–6 daily, dose 1MedDRA: Hiccups — Feeling: Fair · Site: PainFree text: HiccupsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-24
Survey response — day 7, dose 1MedDRA: Unevaluable event — Feeling: Good · Muscle or body achesFree text: Due to my knee an leg problemsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-10
Survey response — day 21, dose 1MedDRA: Ear pain, Respiratory tract congestion — Feeling: FairFree text: Just seems like I have a congestive cold with left ear painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-15
Dose 2 — Moderna
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2021-05-18
Survey response — days 1–6 daily, dose 2MedDRA: Abnormal menstrual clots, Menstruation irregular — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Came on my period,out of nowhere the day I received the shot ,I have had blood clots like never before,an Ian already a heavy bleeder but the week before shot I have been spotting here an there for bout a week an that was BEFORE shot same day of shot I have bleeder heavy with brownish blood an also heard some thick blood drop in the toilet,I didn't know what it was at firstMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-22
Survey response — day 7, dose 2MedDRA: Haemorrhage, Thrombosis — Feeling: Fair · Chills, Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activitiesFree text: I have been bleeding since th day of my second shot,just about everytime I go to the bathroom blood clots of blob fall in the toiletMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-31
Survey response — day 14, dose 2MedDRA: Haemorrhage, Thrombosis — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: I have been bleeding constantly with blood clots,have been given megestrol acetate to stop it now it's coming backckMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-31
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-13
- 2022-02-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-17 | Moderna | |
| 2 | 2021-05-15 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Hiccups
Release 7 — day 7, dose 1
Systemic reaction (other): Due to my knee an leg problems
Release 8 — day 21, dose 1
Symptoms: Just seems like I have a congestive cold with left ear pain
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Came on my period,out of nowhere the day I received the shot ,I have had blood clots like never before,an Ian already a heavy bleeder but the week before shot I have been spotting here an there for bout a week an that was BEFORE shot same day of shot I have bleeder heavy with brownish blood an also heard some thick blood drop in the toilet,I didn't know what it was at first
Release 8 — day 7, dose 2
Systemic reaction (other): I have been bleeding since th day of my second shot,just about everytime I go to the bathroom blood clots of blob fall in the toilet
Release 8 — day 14, dose 2
Symptoms: I have been bleeding constantly with blood clots,have been given megestrol acetate to stop it now it's coming backck
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 | Ear pain | ✓ | ✓ | ✓ |
| SD | Haemorrhage | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | Thrombosis | ✓ | ✓ | ✓ |
| SRO | Abnormal menstrual clots | ✓ | ✓ | ✓ |
| SRO | Haemorrhage | ✓ | ✓ | ✓ |
| SRO | Hiccups | ✓ | ✓ | ✓ |
| SRO | Menstruation irregular | ✓ | ✓ | ✓ |
| SRO | Thrombosis | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release