4X7-32143-69504
5 vaccinations
8 coded responses
50 check-ins
8 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 323 / FL
- Registered
- 2020-12-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-29
Registered in v-safe
-
2020-12-29
Dose 1 — Moderna
- 2020-12-29
-
2020-12-30
Survey response — days 1–6 daily, dose 1MedDRA: Asthenia, Dry mouth, Hyperhidrosis, Syncope — Feeling: Fair · Site: Pain · Fever · Chills, Nausea · Be unable to do your normal daily activitiesFree text: After getting out of bed this morning, I broke out in a sweat, felt weak, exceptionally dry mouth and fainted.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2020-12-30
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities2 call case(s)
-
2020-12-31
Survey response — days 1–6 daily, dose 1MedDRA: Pain, Pain in extremity — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Difficulties raising shot arm due to pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-12
- 2021-01-20
-
2021-01-28
Dose 2 — Moderna
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
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2021-03-11
Survey response — day 42, dose 2MedDRA: Cough, Nasal congestion, Oropharyngeal pain, Sneezing — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sore throat, sneezing, nasal congestion, coughing (croup like). No fever. Probably seasonal allergies.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-29
Survey response — 3 months, dose 2MedDRA: Arthralgia, Cough, Fatigue, Nausea, Oropharyngeal pain, Vomiting — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Nauseated, vomited, fatigue and joint pain. Recovered but today I woke up with a sore throat, cough and shoulders hurt.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-29
Survey response — 6 months, dose 2MedDRA: Nasopharyngitis, Productive cough, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Cold, productive cough, low grade feverMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-29
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-03
-
2021-08-05
Call successfulCompleted over the phone
-
2021-08-05
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-09-19
Dose 3 — Moderna
- 2021-10-24
- 2021-10-31
- 2021-12-19
- 2022-03-20
-
2022-04-19
Dose 4 — Moderna
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-05-03
-
2022-05-10
Survey response — day 21, dose 4MedDRA: Cough, Fatigue, Headache, Pyrexia, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Cough, congestion, headache, low grade fever, and fatigue.MedDRA releases: 2024-11 · check-in free text available
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2022-05-17
Survey response — day 28, dose 4MedDRA: Cough, Discharge, Increased viscosity of upper respiratory secretion, Sinus congestion, Sputum discoloured — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Continue coughing and sinus congestion and drainage (thick green, yellow)MedDRA releases: 2024-11 · check-in free text available
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2022-05-17
Report sent to call center — day 28, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-05-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-24
- 2022-05-31
- 2022-07-21
-
2022-10-01
Dose 5 — ModernaCo-administered: Flu
-
2022-10-17
Survey response — day 14, dose 5MedDRA: Cough, Sneezing, Wheezing — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Chronic cough and wheezing. Some sneezing attacks.MedDRA releases: 2024-11 · check-in free text available
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2022-10-17
Report sent to call center — day 14, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-10-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-22
- 2022-10-29
- 2022-11-05
- 2022-11-12
- 2022-12-31
- 2023-04-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-29 | Moderna | |
| 2 | 2021-01-28 | Moderna | |
| 3 | 2021-09-19 | Moderna | No |
| 4 | 2022-04-19 | Moderna | No |
| 5 | 2022-10-01 | Moderna | Flu |
Call center
5 call center cases
4 successful · 1 priority 2/3 (triaged and no follow up)
VAERS report filed, before or during a call: 1
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): After getting out of bed this morning, I broke out in a sweat, felt weak, exceptionally dry mouth and fainted.
Systemic reaction (other): Difficulties raising shot arm due to pain.
Release 5 — day 42, dose 2
Symptoms: Sore throat, sneezing, nasal congestion, coughing (croup like). No fever. Probably seasonal allergies.
Release 8 — 3 months, dose 2
Symptoms: Nauseated, vomited, fatigue and joint pain. Recovered but today I woke up with a sore throat, cough and shoulders hurt.
Release 9 — 6 months, dose 2
Symptoms: Cold, productive cough, low grade fever
Release 11 — day 21, dose 4
Symptoms: Cough, congestion, headache, low grade fever, and fatigue.
Release 11 — day 28, dose 4
Symptoms: Continue coughing and sinus congestion and drainage (thick green, yellow)
Release 12 — day 14, dose 5
Symptoms: Chronic cough and wheezing. Some sneezing attacks.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Discharge | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Increased viscosity of upper respiratory secretion | · | · | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Productive cough | ✓ | · | ✓ |
| SD | Pyrexia | ✓ | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SD | Sputum discoloured | · | · | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
| SD | Wheezing | · | · | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Injected limb mobility decreased | ○ | ○ | ○ |
| SRO | Injection site pain | ○ | ○ | ○ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release