52Q-21041-64654
4 vaccinations
18 coded responses
32 check-ins
18 free-text entries
6 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 598 / MT
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-02
Registered in v-safe
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2021-03-02
Dose 1 — Moderna
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2021-03-05
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Eye inflammation, Sinusitis — Feeling: Poor · Chills, Abdominal pain · Be unable to do your normal daily activitiesFree text: Having a bad eye inflammation and sinus inflammationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Eye swelling, Paranasal sinus inflammation, Sensitivity to weather change — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: The first snow melt is very hard on me. Can't tell what might be from that or the I got an eye swelling and sinus swelling the day before my shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-09
Survey response — day 7, dose 1MedDRA: Asthenia, Pelvic pain — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: Pelvis pain for the last two or three days. Very weak this morning but much better this afternoon.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
- 2021-03-23
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2021-03-30
Dose 2 — Moderna
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2021-03-30
Survey response — day 0, dose 2MedDRA: Injection site paraesthesia, Pain in extremity — Feeling: Good · Be unable to do your normal daily activitiesFree text: Mild arm pain and tingling from injection site to handsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Dyskinesia, Hyperventilation, Sleep disorder — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Hyperventilated last night when I was trying to sleep. Had an arms jerkMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesAdult check-in
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2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesAdult check-in
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2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Neck pain, Pain in jaw — Feeling: Poor · Site: Itching · Chills · Be unable to workFree text: Bad jaw and neck pain, lower back alsoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Poor quality sleep, Pre-existing disease, Stress — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: A few days of extreme stress and very little sleep I think is the main culprit of my extreme fibromyalgia symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Neck pain, Pain in jaw, Rash — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: A rash on my face that is unusual and that I've had since the immunization. Neck and jaw pain still much stronger than normalMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-06
Survey response — day 7, dose 2MedDRA: Fatigue — Feeling: Good · Fatigue or tirednessFree text: Just extreme fatigue today because I was up very late taking care of an emergency toilet overflow issueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-13
- 2021-04-20
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2021-04-27
Survey response — day 28, dose 2MedDRA: Diarrhoea, Fatigue, Pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Intermittent diarrhea. Extreme extreme fatigue and strong pain below my clavicle on the right side. I am going to go to the doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-05
- 2021-05-13
- 2021-06-29
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2021-09-13
Dose 3 — ModernaCo-administered: Flu
- 2021-09-29
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2021-10-27
Survey response — day 42, dose 3MedDRA: Hypersensitivity, Oropharyngeal blistering, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: I've been having a little blisters at the back of my throat. Allergy triggered my immune system seems very very overly sensitive right now. I am disabled to begin with though. I had a flu shot at the same time as my third Covid.MedDRA releases: 2024-11 · check-in free text available
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2021-10-27
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
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2021-10-28
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2021-12-13
Survey response — 3 months, dose 3MedDRA: Mammogram abnormal, Skin lesion — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I don't know the details yet and I don't know if it's new but I failed my mammogram and I got a biopsy and I will get details tomorrow but I am told that it's not cancer but it was an eighth of an inch lesion of some sort itMedDRA releases: 2024-11 · check-in free text available
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2021-12-13
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-14
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2022-04-06
Dose 4 — Moderna
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2022-04-14
Survey response — day 7, dose 4MedDRA: Oedema peripheral, Oropharyngeal pain — Feeling: Fair · Site: Swelling · Chills, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Mildly sore throat. Underarm of shot site was severely swollen getting betterMedDRA releases: 2024-11 · check-in free text available
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2022-04-14
Report sent to call center — day 7, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
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2022-04-19
Call successfulParticipant prefers to complete VAERS report online
- 2022-04-23
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2022-04-27
Survey response — day 21, dose 4MedDRA: Asthenia, Blood test abnormal, Fatigue, Liver disorder, Muscle spasms, Pruritus, Renal disorder, Tinnitus — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Bloodwork showed my liver and kidneys not doing so well. Loud ear ringing itchy all over cramps liver and weak/tiredMedDRA releases: 2024-11 · check-in free text available
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2022-05-04
Survey response — day 28, dose 4MedDRA: Ear discomfort, Facial pain, Malaise, Nasal congestion, Nasopharyngitis, Pain in jaw — Feeling: PoorFree text: I think I caught a cold from my granddaughter so my nose is very plugged up, my face and jaw hurt and my ear is bothering me and I feel pretty terrible.MedDRA releases: 2024-11 · check-in free text available
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2022-05-11
Survey response — day 35, dose 4MedDRA: Cough, Sinus congestion, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Terribly stuffed sinuses, bad cough. Ringing earsMedDRA releases: 2024-11 · check-in free text available
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2022-05-11
Report sent to call center — day 35, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-05-12
Call successfulCompleted over the phone
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2022-05-12
Call successfulCompleted over the phone
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2022-05-18
Survey response — day 42, dose 4MedDRA: COVID-19 — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: I've lost track at this point but I was diagnosed with my second round of Covid on May 8. Previous to that I was diagnosed positive for Covid January 12. I have had four immunizationsMedDRA releases: 2024-11 · check-in free text available
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2022-05-18
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
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2022-05-19
Call successfulDoes not wish to fill out VAERS report
- 2022-07-06
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2022-10-07
Survey response — 6 months, dose 4MedDRA: COVID-19, Disability, Dysgeusia, Fatigue, Fibromyalgia, General physical condition abnormal, Office visit, Parosmia, Post-acute COVID-19 syndrome — 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: My doctor has diagnosed me with long Covid. I'm just excruciatingly tired. Horrible taste in my mouth and a weird sense of smell. Bad fibromyalgia. Low Endurance. I was already disabled before I had the COVID's And this is a definite step back worse · Healthcare visit (other): A visit with my doctorMedDRA releases: 2024-11 · check-in free text available
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2022-10-07
Report sent to call center — 6 months, dose 4Be 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)
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2022-10-10
Call successfulReported to VAERS during previous contact from GDIT
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna | |
| 3 | 2021-09-13 | Moderna | Flu |
| 4 | 2022-04-06 | Moderna | No |
Call center
6 call center cases
6 successful
VAERS report filed, before or during a call: 3
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Having a bad eye inflammation and sinus inflammation
Systemic reaction (other): The first snow melt is very hard on me. Can't tell what might be from that or the I got an eye swelling and sinus swelling the day before my shot.
Release 5 — day 7, dose 1
Systemic reaction (other): Pelvis pain for the last two or three days. Very weak this morning but much better this afternoon.
Release 6 — day 0, dose 2
Systemic reaction (other): Mild arm pain and tingling from injection site to hands
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Hyperventilated last night when I was trying to sleep. Had an arms jerk
Systemic reaction (other): Bad jaw and neck pain, lower back also
Systemic reaction (other): A few days of extreme stress and very little sleep I think is the main culprit of my extreme fibromyalgia symptoms
Systemic reaction (other): A rash on my face that is unusual and that I've had since the immunization. Neck and jaw pain still much stronger than normal
Release 7 — day 7, dose 2
Systemic reaction (other): Just extreme fatigue today because I was up very late taking care of an emergency toilet overflow issue
Release 8 — day 28, dose 2
Symptoms: Intermittent diarrhea. Extreme extreme fatigue and strong pain below my clavicle on the right side. I am going to go to the doctor
Release 10 — day 42, dose 3
Symptoms: I've been having a little blisters at the back of my throat. Allergy triggered my immune system seems very very overly sensitive right now. I am disabled to begin with though. I had a flu shot at the same time as my third Covid.
Release 10 — 3 months, dose 3
Symptoms: I don't know the details yet and I don't know if it's new but I failed my mammogram and I got a biopsy and I will get details tomorrow but I am told that it's not cancer but it was an eighth of an inch lesion of some sort it
Release 11 — day 7, dose 4
Systemic reaction (other): Mildly sore throat. Underarm of shot site was severely swollen getting better
Release 11 — day 21, dose 4
Symptoms: Bloodwork showed my liver and kidneys not doing so well. Loud ear ringing itchy all over cramps liver and weak/tired
Release 11 — day 28, dose 4
Symptoms: I think I caught a cold from my granddaughter so my nose is very plugged up, my face and jaw hurt and my ear is bothering me and I feel pretty terrible.
Release 11 — day 35, dose 4
Symptoms: Terribly stuffed sinuses, bad cough. Ringing ears
Release 11 — day 42, dose 4
Symptoms: I've lost track at this point but I was diagnosed with my second round of Covid on May 8. Previous to that I was diagnosed positive for Covid January 12. I have had four immunizations
Release 12 — 6 months, dose 4
Symptoms: My doctor has diagnosed me with long Covid. I'm just excruciatingly tired. Horrible taste in my mouth and a weird sense of smell. Bad fibromyalgia. Low Endurance. I was already disabled before I had the COVID's And this is a definite step back worse cut off by CDC
Healthcare visit (other): A visit with my doctor
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 | Asthenia | · | · | ✓ |
| SD | Blood test abnormal | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Disability | · | · | ✓ |
| SD | Dysgeusia | · | · | ✓ |
| SD | Ear discomfort | · | · | ✓ |
| SD | Facial pain | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Fibromyalgia | · | · | ✓ |
| SD | General physical condition abnormal | · | · | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Liver disorder | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Mammogram abnormal | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal blistering | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in jaw | · | · | ✓ |
| SD | Parosmia | · | · | ✓ |
| SD | Post-acute COVID-19 syndrome | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Renal disorder | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Skin lesion | · | · | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Dyskinesia | ✓ | ✓ | ✓ |
| SRO | Eye inflammation | ✓ | ✓ | ✓ |
| SRO | Eye swelling | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Hyperventilation | ✓ | ✓ | ✓ |
| SRO | Injection site paraesthesia | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Paranasal sinus inflammation | ✓ | ✓ | ✓ |
| SRO | Pelvic pain | ✓ | ✓ | ✓ |
| SRO | Poor quality sleep | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Sensitivity to weather change | ✓ | ✓ | ✓ |
| SRO | Sinusitis | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ✓ |
| SRO | Stress | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release