534-23344-67864
2 vaccinations
5 coded responses
13 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 327 / FL
- Registered
- 2021-03-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-23
Dose 1 — Moderna
-
2021-03-25
Registered in v-safe
-
2021-03-25
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
- 2021-03-26
- 2021-03-28
- 2021-03-29
- 2021-03-30
-
2021-04-06
Survey response — day 14, dose 1MedDRA: Discharge, Infection, Pre-existing disease, Radiculitis brachial, Sinusitis — Feeling: GoodFree text: I was born with a brachial cleft abnormality hole in my neck. It hasn't drained for a while until this week and it has an infection because it's green. This usually happens if I have a sinus infection but I haven't had anything but shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
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2021-04-20
Dose 2 — Moderna
- 2021-04-27
- 2021-05-04
-
2021-05-11
Survey response — day 21, dose 2MedDRA: Brain fog, Disturbance in attention — Feeling: FairFree text: Brain fog, loss of concentration, but trying to push through it, so I will check none of the above for nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-03
Survey response — day 42, dose 2MedDRA: Arthralgia, Myalgia — Feeling: GoodFree text: Joints, muscles acheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-20
Survey response — 3 months, dose 2MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: All joints hurt. Don't know why.MedDRA releases: 2024-11 · check-in free text available
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2021-10-19
Survey response — 6 months, dose 2MedDRA: Arthralgia, Cataract, Office visit, Urinary tract infection, Visual impairment — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: 2 UTIs. Joints still ache. Sudden Diminished sight Cataracts since vaccinations, confirmed 10-18-21 · Healthcare visit (other): Dr ofc visitMedDRA releases: 2024-11 · check-in free text available
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2021-10-19
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-10-22
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2021-11-08
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-23 | Moderna | |
| 2 | 2021-04-20 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 7 — day 14, dose 1
Symptoms: I was born with a brachial cleft abnormality hole in my neck. It hasn't drained for a while until this week and it has an infection because it's green. This usually happens if I have a sinus infection but I haven't had anything but shot.
Release 8 — day 21, dose 2
Symptoms: Brain fog, loss of concentration, but trying to push through it, so I will check none of the above for now
Release 8 — day 42, dose 2
Symptoms: Joints, muscles ache
Release 9 — 3 months, dose 2
Symptoms: All joints hurt. Don't know why.
Release 10 — 6 months, dose 2
Symptoms: 2 UTIs. Joints still ache. Sudden Diminished sight Cataracts since vaccinations, confirmed 10-18-21
Healthcare visit (other): Dr ofc visit
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Brain fog | ✓ | ✓ | ✓ |
| SD | Cataract | · | · | ✓ |
| SD | Discharge | ✓ | · | ✓ |
| SD | Disturbance in attention | ✓ | ✓ | ✓ |
| SD | Infection | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | Radiculitis brachial | ○ | ✓ | ○ |
| SD | Sinusitis | ○ | ✓ | ○ |
| SD | Urinary tract infection | · | · | ✓ |
| SD | Visual impairment | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release