4XB-25973-69051
3 vaccinations
10 coded responses
29 check-ins
10 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 787 / TX
- Registered
- 2021-04-17
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
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2021-03-18
Dose 1 — Moderna
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2021-04-17
Registered in v-safe
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2021-04-17
Dose 2 — Moderna
- 2021-04-17
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2021-04-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Tenderness — Feeling: GoodFree text: Upper arm is just a little tender but not painful.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
- 2021-04-22
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2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: Contusion, Heavy menstrual bleeding, Menstruation irregular — Feeling: GoodFree text: Unexplained bruises on back of left leg (calf). Heavy, unexpected period. Period started 2 weeks after last period, 3 days after vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-24
Survey response — day 7, dose 2MedDRA: Contusion — Feeling: GoodFree text: Still have bruise on leg and weird period.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
- 2021-05-08
- 2021-05-15
- 2021-05-24
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2021-05-29
Survey response — day 42, dose 2MedDRA: Unevaluable event — Feeling: FairFree text: I discovered a bald spot about the size of a quarter on the side of my head. Rest of my hair covers it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-19
- 2021-10-16
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2021-12-11
Dose 3 — Moderna
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2021-12-12
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Discharge — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Mild cough, some drainageMedDRA releases: 2024-11 · check-in free text available
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2021-12-13
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-12-14
Survey response — days 1–6 daily, dose 3MedDRA: Heavy menstrual bleeding — Feeling: Good · Site: Redness, SwellingFree text: Menstrual cycle is a little heavier than usual.MedDRA releases: 2024-11 · check-in free text available
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2021-12-15
Survey response — days 1–6 daily, dose 3MedDRA: Heavy menstrual bleeding — Feeling: Good · Site: Redness, SwellingFree text: Heavier period than what is usual for me.MedDRA releases: 2024-11 · check-in free text available
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2021-12-16
Survey response — days 1–6 daily, dose 3MedDRA: Heavy menstrual bleeding — Feeling: GoodFree text: Heavier than usual periodMedDRA releases: 2024-11 · check-in free text available
- 2021-12-17
- 2021-12-18
- 2021-12-25
- 2022-01-01
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2022-01-08
Survey response — day 28, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: GoodFree text: I have prior diagnosed condition of Alopecia Areata. Haven't had a case about 10 years. I noticed a balding spot a few weeks after my 2 original vaccinations. Hair started growing back. Now a few weeks after booster, I have a new bald spot.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-17
- 2022-01-22
- 2022-03-12
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2022-06-11
Survey response — 6 months, dose 3MedDRA: COVID-19, Office visit — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Diagnosed with covid 19 · Healthcare visit (other): In person visit with drMedDRA releases: 2024-11 · check-in free text available
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2022-06-11
Report sent to call center — 6 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 pr1 call case(s)
- 2022-06-13
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2022-06-16
Call successfulCompleted over the phone
- 2022-12-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-17 | Moderna | |
| 3 | 2021-12-11 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Upper arm is just a little tender but not painful.
Systemic reaction (other): Unexplained bruises on back of left leg (calf). Heavy, unexpected period. Period started 2 weeks after last period, 3 days after vaccine.
Release 7 — day 7, dose 2
Systemic reaction (other): Still have bruise on leg and weird period.
Release 8 — day 42, dose 2
Symptoms: I discovered a bald spot about the size of a quarter on the side of my head. Rest of my hair covers it.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Mild cough, some drainage
Systemic reaction (other): Menstrual cycle is a little heavier than usual.
Systemic reaction (other): Heavier period than what is usual for me.
Systemic reaction (other): Heavier than usual period
Release 10 — day 28, dose 3
Symptoms: I have prior diagnosed condition of Alopecia Areata. Haven't had a case about 10 years. I noticed a balding spot a few weeks after my 2 original vaccinations. Hair started growing back. Now a few weeks after booster, I have a new bald spot.
Release 12 — 6 months, dose 3
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 | Condition aggravated | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Contusion | ✓ | ✓ | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Discharge | · | · | ✓ |
| SRO | Heavy menstrual bleeding | ✓ | ✓ | ✓ |
| SRO | Menstruation irregular | ✓ | ✓ | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release