4WX-28212-36349
6 vaccinations
16 coded responses
62 check-ins
15 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 919 / CA
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Registered in v-safe
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2021-01-14
Dose 1 — Moderna
- 2021-01-14
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2021-01-15
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Fatigue or tirednessFree text: Vital all normalMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-16
- 2021-01-17
- 2021-01-18
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2021-01-19
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: (b)(6) Vaccination Sote has recorded the wrong date for my vaccination. I was vaccinated on the Jan 14 and they have listed the 25th. I am trying to get this corrected. There have been recording problems per the tech at (b)(6) for MyChart.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-28
- 2021-02-04
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2021-02-11
Dose 2 — Moderna
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2021-02-11
Survey response — day 0, dose 2MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: Did not take ibuprofen or acetaminophen this time. Just dont feel good. Vaccine must be working!!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Pyrexia — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Improved from yesterday. Fever gone. Yaaaay!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Pruritus, Self-medication — Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Took benedryl because site itching was so bad.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
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2021-02-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
-
2021-02-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Headache, Joint pains · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-17
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-05-13
- 2021-08-12
-
2021-08-30
Dose 3 — ModernaCo-administered: Flu
-
2021-11-29
Survey response — 3 months, dose 3MedDRA: Cough, Pre-existing disease, Secretion discharge, Throat irritation — Feeling: GoodFree text: Scratchy throat, slight cough, increased mucous (clear). Feels like allergies due to recent Santa Ana weather conditions & local area fire air particulate matter.MedDRA releases: 2024-11 · check-in free text available
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2022-01-31
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-01-31
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2022-02-01
Survey response — days 1–6 daily, dose 4MedDRA: Headache, Pre-existing disease, Pyrexia — Feeling: Good · Site: Pain · Fever · HeadacheFree text: Headache feels like an overfilled balloon, maybe sinus. I am not at all convinced the headache is related to vaccine. Very mild and I had it day before vaccine. Same thing with low grade fever temp. Not related to vaccine. Antigen and PCR both negatiMedDRA releases: 2024-11 · check-in free text available
- 2022-02-02
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2022-02-03
Survey response — days 1–6 daily, dose 4MedDRA: Respiratory syncytial virus infection — Feeling: Good · Site: Redness, Itching · Fatigue or tirednessFree text: RSV dbl blind study participant with Velocity ResearchMedDRA releases: 2024-11 · check-in free text available
- 2022-02-04
- 2022-02-05
-
2022-02-06
Survey response — days 1–6 daily, dose 4MedDRA: Eczema — Feeling: Good · Site: ItchingFree text: Eczema on left ankle bothering me, too.MedDRA releases: 2024-11 · check-in free text available
- 2022-02-07
- 2022-02-14
- 2022-02-21
- 2022-02-28
- 2022-03-07
- 2022-03-14
- 2022-05-02
-
2022-06-13
Dose 5 — Pfizer-BioNTech
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2022-06-14
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2022-06-15
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
- 2022-06-16
- 2022-06-17
- 2022-06-18
- 2022-06-19
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2022-06-20
Survey response — day 7, dose 5MedDRA: Fluid retention, Weight increased — Feeling: Good · Fatigue or tirednessFree text: Water weight gainMedDRA releases: 2024-11 · check-in free text available
- 2022-06-27
- 2022-07-04
- 2022-07-11
- 2022-07-18
- 2022-07-25
- 2022-09-12
-
2022-10-01
Dose 6 — Pfizer-BioNTechCo-administered: Flu
-
2022-10-06
Health check-in — days 1–6 daily, dose 6Feeling: Good · Joint pains, Fatigue or tirednessAdult check-in
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2022-10-07
Survey response — days 1–6 daily, dose 6MedDRA: Inflammation — Feeling: Good · Joint pains, Muscle or body achesFree text: InflammationMedDRA releases: 2024-11 · check-in free text available
- 2022-10-08
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2022-10-15
Survey response — day 14, dose 6MedDRA: Arthritis, Myalgia, Oedema, Oedema peripheral, Pain, Physiotherapy, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Muscular soreness, edema in legs · Healthcare visit (other): PT for edema & soreness from worsened arthritis.MedDRA releases: 2024-11 · check-in free text available
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2022-10-15
Report sent to call center — day 14, dose 6Get care from a doctor or other healthcare professional1 call case(s)
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2022-10-17
Call successfulDoes not wish to fill out VAERS report
- 2022-10-22
-
2022-10-29
Survey response — day 28, dose 6MedDRA: Arthralgia, Arthritis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Joint pain & inflammationMedDRA releases: 2024-11 · check-in free text available
- 2022-11-05
-
2022-11-12
Survey response — day 42, dose 6MedDRA: Arthralgia, Inflammation, Myalgia, Office visit, Physiotherapy — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Inflammation & sore joints / muscles · Healthcare visit (other): Office visit with Naprosyn 250 mg prescribed, PT for bilateral knee pain, MRI w/ & w/out contrast scheduled.MedDRA releases: 2024-11 · check-in free text available
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2022-11-12
Report sent to call center — day 42, dose 6Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2022-11-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-12-31
Survey response — 3 months, dose 6MedDRA: Non-tobacco user, Office visit, Oral disorder — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Tongue lesions on side of tongue. Getting approval for biopsy as neither primary physician nor my dentist likes the look of it, especially since I don't have risk factors for tongue cancer. Oral surgeon wants to biopsy it. Non-smoker. · Healthcare visit (other): Visit to dentist, primary care physician, and oral surgeon for biopsyMedDRA releases: 2024-11 · check-in free text available
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2022-12-31
Report sent to call center — 3 months, dose 6Get care from a doctor or other healthcare professional1 call case(s)
-
2023-01-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-04-01
Survey response — 6 months, dose 6MedDRA: Cough, Heart rate decreased, Medical counselling, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-04-01
Report sent to call center — 6 months, dose 6Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
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2023-04-03
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2021-08-30 | Moderna | Flu |
| 4 | 2022-01-31 | Pfizer-BioNTech | Flu |
| 5 | 2022-06-13 | Pfizer-BioNTech | No |
| 6 | 2022-10-01 | Pfizer-BioNTech | Flu |
Call center
4 call center cases
4 successful
VAERS report filed, before or during a call: 1
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Vital all normal
Systemic reaction (other): (b)(6) Vaccination Sote has recorded the wrong date for my vaccination. I was vaccinated on the Jan 14 and they have listed the 25th. I am trying to get this corrected. There have been recording problems per the tech at (b)(6) for MyChart.
redacted (b)(6)
Release 4 — day 0, dose 2
Systemic reaction (other): Did not take ibuprofen or acetaminophen this time. Just dont feel good. Vaccine must be working!!
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Improved from yesterday. Fever gone. Yaaaay!
Systemic reaction (other): Took benedryl because site itching was so bad.
Release 10 — 3 months, dose 3
Symptoms: Scratchy throat, slight cough, increased mucous (clear). Feels like allergies due to recent Santa Ana weather conditions & local area fire air particulate matter.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Headache feels like an overfilled balloon, maybe sinus. I am not at all convinced the headache is related to vaccine. Very mild and I had it day before vaccine. Same thing with low grade fever temp. Not related to vaccine. Antigen and PCR both negati cut off by CDC
Systemic reaction (other): RSV dbl blind study participant with Velocity Research
Systemic reaction (other): Eczema on left ankle bothering me, too.
Release 12 — day 7, dose 5
Systemic reaction (other): Water weight gain
Release 12 — days 1–6 daily, dose 6
Systemic reaction (other): Inflammation
Release 12 — day 14, dose 6
Symptoms: Muscular soreness, edema in legs
Healthcare visit (other): PT for edema & soreness from worsened arthritis.
Release 12 — day 28, dose 6
Symptoms: Joint pain & inflammation
Release 12 — day 42, dose 6
Symptoms: Inflammation & sore joints / muscles
Healthcare visit (other): Office visit with Naprosyn 250 mg prescribed, PT for bilateral knee pain, MRI w/ & w/out contrast scheduled.
Release 12 — 3 months, dose 6
Symptoms: Tongue lesions on side of tongue. Getting approval for biopsy as neither primary physician nor my dentist likes the look of it, especially since I don't have risk factors for tongue cancer. Oral surgeon wants to biopsy it. Non-smoker.
Healthcare visit (other): Visit to dentist, primary care physician, and oral surgeon for biopsy
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 | Arthralgia | · | · | ✓ |
| HCVO | Arthritis | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Oedema | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Pain | · | · | ✓ |
| HCVO | Physiotherapy | · | · | ✓ |
| HCVO | Pre-existing disease | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Arthritis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Heart rate decreased | · | · | ✓ |
| SD | Inflammation | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Non-tobacco user | · | · | ✓ |
| SD | Oedema peripheral | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oral disorder | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Secretion discharge | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Eczema | · | · | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Fluid retention | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Inflammation | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Respiratory syncytial virus infection | · | · | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Weight increased | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release