4TX-25381-79243
3 vaccinations
7 coded responses
14 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 115 / NY
- Registered
- 2021-12-21
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
H9A-84941-47814
Child or adolescent in my care · Male · 2021-12-21
AFV-24994-23298
Child or adolescent in my care · Male · 2021-12-21
3YF-10907-80598
Child or adolescent in my care · Male · 2021-12-21
Timeline
-
2021-04-16
Dose 1 — Moderna
-
2021-05-14
Dose 2 — Moderna
-
2021-12-21
Registered in v-safe
-
2021-12-22
Dose 3 — Moderna
-
2021-12-23
Survey response — days 1–6 daily, dose 3MedDRA: Blood pressure abnormal, Ear pain, Palpitations — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Stabbing pain behind ears, heart palpitations, issues in blood pressureMedDRA releases: 2024-11 · check-in free text available
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2021-12-24
Survey response — days 1–6 daily, dose 3MedDRA: Hyperhidrosis, Self-medication — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches · Be unable to work or attend schoolFree text: I'm better today, less dependent on Tylenol and sweating is helping my body feel betterMedDRA releases: 2024-11 · check-in free text available
-
2021-12-25
Survey response — days 1–6 daily, dose 3MedDRA: Chest discomfort, Dizziness, Heart rate irregular, Hyperhidrosis — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Dizzy sweaty n heart beat is irregular ponding chestMedDRA releases: 2024-11 · check-in free text available
-
2021-12-26
Survey response — days 1–6 daily, dose 3MedDRA: Palpitations — Feeling: GoodFree text: Heart beat isn't very good I feel my heart pounding out of my chest at times then it becomes normal againMedDRA releases: 2024-11 · check-in free text available
- 2021-12-28
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2021-12-29
Survey response — day 7, dose 3MedDRA: Pre-existing disease, Tinnitus — Feeling: GoodFree text: Tinnitus is worsened after booster shotMedDRA releases: 2024-11 · check-in free text available
- 2022-01-05
-
2022-01-13
Survey response — day 21, dose 3MedDRA: Ear discomfort, Odynophagia, Oropharyngeal pain, Pain, Rhinorrhoea, Sputum discoloured — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Body aches. Sore throat. Sputum is yellow orange. Throat hurts during swallowing. Runny nose. Ears feel plugged.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-19
- 2022-01-26
- 2022-02-02
- 2022-03-23
- 2022-06-24
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2022-12-23
Survey response — 12 months, dose 3MedDRA: Aphonia, Bronchitis, Secretion discharge, Sinus disorder, Sputum discoloured — Feeling: Good · Be unable to work or attend school, 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: Lingering sinus issues, bronchitis like symptoms no fever. Lots of sputum and mucous even green sputum: lost my voice for a week or more. Things seem bette nowMedDRA releases: 2024-11 · check-in free text available
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2022-12-23
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-16 | Moderna | No |
| 2 | 2021-05-14 | Moderna | No |
| 3 | 2021-12-22 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Stabbing pain behind ears, heart palpitations, issues in blood pressure
Systemic reaction (other): I'm better today, less dependent on Tylenol and sweating is helping my body feel better
Systemic reaction (other): Dizzy sweaty n heart beat is irregular ponding chest
Systemic reaction (other): Heart beat isn't very good I feel my heart pounding out of my chest at times then it becomes normal again
Release 10 — day 7, dose 3
Systemic reaction (other): Tinnitus is worsened after booster shot
Release 10 — day 21, dose 3
Symptoms: Body aches. Sore throat. Sputum is yellow orange. Throat hurts during swallowing. Runny nose. Ears feel plugged.
Release 12 — 12 months, dose 3
Symptoms: Lingering sinus issues, bronchitis like symptoms no fever. Lots of sputum and mucous even green sputum: lost my voice for a week or more. Things seem bette now
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 | Aphonia | · | · | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Ear discomfort | · | · | ✓ |
| SD | Odynophagia | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Secretion discharge | · | · | ✓ |
| SD | Sinus disorder | · | · | ✓ |
| SD | Sputum discoloured | · | · | ✓ |
| SRO | Blood pressure abnormal | · | · | ✓ |
| SRO | Chest discomfort | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | Heart rate irregular | · | · | ✓ |
| SRO | Hyperhidrosis | · | · | ✓ |
| SRO | Palpitations | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release