4YT-28448-20792
2 vaccinations
2 coded responses
17 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 129 / NY
- Registered
- 2021-01-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-04
Registered in v-safe
-
2021-01-04
Dose 1 — Moderna
- 2021-01-04
- 2021-01-06
- 2021-01-07
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-18
- 2021-01-25
-
2021-02-02
Dose 2 — Moderna
-
2021-02-15
Survey response — day 7, dose 2MedDRA: Emergency care, Muscle spasms, Skin discolouration, Syncope — Feeling: Fair · Site: Pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Low magnesium and potassium caused spasms that last over 2 hours. Never had before. First episode Feb 12 and I fainted, went white and hands turned blue. Ambulance ride to hospital. Second time 2/14 , didn't faint but over 2 hrs of spasms. Did not speak medical attentionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-15
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
-
2021-05-04
Survey response — 3 months, dose 2MedDRA: Abdominal discomfort, Chills, Dizziness — Feeling: FairFree text: Starting today I am dizzy/light headed. My boy friend who is not vaccinated has severe headache, upset stomach, chills, no fever yet and overall aches which began Sunday 5/2/2021. His ex wife also not vaccinated I am told has same sx and out of workMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-30
- 2021-08-03
-
2021-08-05
Call successfulCompleted over the phone
- 2022-02-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-02 | Moderna |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
1 wait over 3 months for a first call
Free text
Release 4 — day 7, dose 2
Systemic reaction (other): Low magnesium and potassium caused spasms that last over 2 hours. Never had before. First episode Feb 12 and I fainted, went white and hands turned blue. Ambulance ride to hospital. Second time 2/14 , didn't faint but over 2 hrs of spasms. Did not speak medical attention
Release 8 — 3 months, dose 2
Symptoms: Starting today I am dizzy/light headed. My boy friend who is not vaccinated has severe headache, upset stomach, chills, no fever yet and overall aches which began Sunday 5/2/2021. His ex wife also not vaccinated I am told has same sx and out of work cut off by CDC
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 | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SRO | Emergency care | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Skin discolouration | ✓ | ✓ | ✓ |
| SRO | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release