4Z3-31108-91769
2 vaccinations
3 coded responses
9 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 068 / CT
- Registered
- 2021-05-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-21
Dose 1 — Moderna
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2021-05-05
Registered in v-safe
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2021-05-05
Survey response — day 14, dose 1MedDRA: Brain fog, Deafness, Headache, Hypoaesthesia, Petechiae — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: I got petechiae all over my body, had CBC test done (its OK). Every other day I get pulsating headaches (back of the head and temples). During these episodes hearing in the right ear gets worse, theres slight numbness in the face, brain fog.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-05
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-12
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2021-05-28
Survey response — day 35, dose 1MedDRA: Heavy menstrual bleeding, Specialist consultation, Tension headache — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Tension headaches persist. Period was heavier, but the next one was normal. · Healthcare visit (other): GPMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-28
Report sent to call center — day 35, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-06-03
Dose 2 — Moderna
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2021-06-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-06-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to workAdult check-in
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2021-06-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection siteAdult check-in
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2021-06-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-07-03
Survey response — day 28, dose 2MedDRA: Depression, Insomnia, Petechiae — Feeling: FairFree text: Petechiae keep appearing on my body. Last blood test was normal (in May). Insomnia and depression (due to unrelated cause).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-09-02
- 2022-04-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-21 | Moderna | |
| 2 | 2021-06-03 | Moderna |
Call center
2 call center cases
2 unsuccessful
1 wait over 3 months for a first call
Free text
Release 8 — day 14, dose 1
Symptoms: I got petechiae all over my body, had CBC test done (its OK). Every other day I get pulsating headaches (back of the head and temples). During these episodes hearing in the right ear gets worse, theres slight numbness in the face, brain fog.
Release 8 — day 35, dose 1
Symptoms: Tension headaches persist. Period was heavier, but the next one was normal.
Healthcare visit (other): GP
Release 9 — day 28, dose 2
Symptoms: Petechiae keep appearing on my body. Last blood test was normal (in May). Insomnia and depression (due to unrelated cause).
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 | Specialist consultation | ✓ | ✓ | ✓ |
| SD | Brain fog | ✓ | ✓ | ✓ |
| SD | Deafness | ✓ | ✓ | ✓ |
| SD | Depression | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Heavy menstrual bleeding | ✓ | ✓ | ✓ |
| SD | Hypoaesthesia | ✓ | ✓ | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Petechiae | ✓ | ✓ | ✓ |
| SD | Tension headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release