4XN-26433-77502
4 vaccinations
6 coded responses
40 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 757 / TX
- Registered
- 2021-01-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Registered in v-safe
-
2021-01-19
Dose 1 — Moderna
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2021-01-19
Survey response — day 0, dose 1MedDRA: Erythema, Headache — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Red face, terrible awful headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-21
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · Site: Pain · HeadacheFree text: Headache may have just been sinus issuesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-03-02
-
2021-03-06
Dose 2 — Moderna
-
2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
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2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-20
- 2021-03-28
-
2021-04-03
Survey response — day 28, dose 2MedDRA: Bladder pain, Renal pain — Feeling: FairFree text: Didn't think it was related til I thought about it. Kidney/bladder pain ever since one week after 2nd vaccination. Every day since. No temp.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-11
- 2021-04-17
-
2021-09-01
Dose 3 — Moderna
- 2021-09-06
-
2022-03-02
Survey response — 6 months, dose 3MedDRA: Asthma, Brain fog, COVID-19, Dyspnoea, Fatigue, Visual impairment — 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 professional · Telehealth, virtual health, or email health consultationFree text: Late Dec-early Jan I had Covid, the next week Covid induced asthma, next week Covid induced asthma attack. I've had vision issues, brain fog, fatigue, shortness of breathMedDRA releases: 2024-11 · check-in free text available
-
2022-03-02
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 prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-03-03
- 2022-03-08
-
2022-04-30
Dose 4 — Moderna
- 2022-04-30
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2022-05-01
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-05-02
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-05-03
Survey response — days 1–6 daily, dose 4MedDRA: Insomnia — Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body achesFree text: Trouble sleepingMedDRA releases: 2024-11 · check-in free text available
-
2022-05-04
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body achesAdult check-in
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-16
- 2022-05-21
- 2022-05-28
- 2022-06-05
- 2022-06-13
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2022-07-30
Survey response — 3 months, dose 4MedDRA: Hypoaesthesia, Myalgia, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Muscle pain and numbness in hands, wrists · Healthcare visit (other): Regular appt where discussedMedDRA releases: 2024-11 · check-in free text available
-
2022-07-30
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
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2022-08-01
Call successfulDoes not wish to fill out VAERS report
- 2022-10-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-03-06 | Moderna | |
| 3 | 2021-09-01 | Moderna | No |
| 4 | 2022-04-30 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): Red face, terrible awful headache
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Headache may have just been sinus issues
Release 6 — day 28, dose 2
Symptoms: Didn't think it was related til I thought about it. Kidney/bladder pain ever since one week after 2nd vaccination. Every day since. No temp.
Release 11 — 6 months, dose 3
Symptoms: Late Dec-early Jan I had Covid, the next week Covid induced asthma, next week Covid induced asthma attack. I've had vision issues, brain fog, fatigue, shortness of breath
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Trouble sleeping
Release 12 — 3 months, dose 4
Symptoms: Muscle pain and numbness in hands, wrists
Healthcare visit (other): Regular appt where discussed
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 | Asthma | · | · | ✓ |
| SD | Bladder pain | ✓ | ✓ | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Hypoaesthesia | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Renal pain | ✓ | ✓ | ✓ |
| SD | Visual impairment | · | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Insomnia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release