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556-29803-61208

1 vaccination 2 coded responses 5 check-ins 2 free-text entries 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
615 / IL
Registered
2021-04-18
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-23
    Dose 1 — Moderna
  2. 2021-04-18
    Registered in v-safe
  3. 2021-04-18
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  4. 2021-04-20
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-06-22
    Health check-in — 3 months, dose 1
    Feeling: Fair
    Adult check-in
  6. 2021-09-21
    Survey response — 6 months, dose 1
    MedDRA: Gait disturbance, Neuropathy peripheral, Office visit, Pain in extremity, Pre-existing disease, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Nerothopy which causes my right leg to drag and the pain is so bad ialso suffer from a botched left hip replacement both knees bone on bone for 3 or 4 years and Vericose veins. Waist down i suffer tremendously and need someone to help me with chronic · Healthcare visit (other): Doctor appointment
    MedDRA releases: 2024-11 · check-in free text available
  7. 2021-09-21
    Report sent to call center — 6 months, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  8. 2021-09-23
    Call successful
    Does not wish to fill out VAERS report
  9. 2022-03-25
    Survey response — 12 months, dose 1
    MedDRA: Foot operation, Stent placement, Toe amputation — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Surgery on right foot as I had cross over's and they amputated the second first toe. 6 weeks recovery then they doing the other foot then another 6 weeks. Another surgery to remove the other stent.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-03-23Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 9 — 6 months, dose 1

2021-09-21

Symptoms: Nerothopy which causes my right leg to drag and the pain is so bad ialso suffer from a botched left hip replacement both knees bone on bone for 3 or 4 years and Vericose veins. Waist down i suffer tremendously and need someone to help me with chronic cut off by CDC
Healthcare visit (other): Doctor appointment

Release 11 — 12 months, dose 1

2022-03-25

Symptoms: Surgery on right foot as I had cross over's and they amputated the second first toe. 6 weeks recovery then they doing the other foot then another 6 weeks. Another surgery to remove the other stent.

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
SDFoot operation · · ✓
SDGait disturbance · · ✓
SDNeuropathy peripheral · · ✓
SDPain in extremity · · ✓
SDPre-existing disease · · ✓
SDStent placement · · ✓
SDToe amputation · · ✓
SDUnevaluable event · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release