579-28208-31189
3 vaccinations
5 coded responses
23 check-ins
5 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 331 / FL
- Registered
- 2021-03-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-23
Dose 1 — Moderna
-
2021-03-24
Registered in v-safe
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2021-03-24
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-25
Survey response — days 1–6 daily, dose 1MedDRA: Muscle spasms, Respiratory arrest — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Chest spasm, unable to breathe for approx 10 secondsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-26
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Joint pains, Muscle or body achesAdult check-in
- 2021-03-28
- 2021-03-29
- 2021-04-01
- 2021-04-06
- 2021-04-14
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2021-04-20
Dose 2 — Moderna
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2021-04-20
Health check-in — day 0, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-21
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Arm numbness/tinglingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-23
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-24
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Joint pains, Muscle or body achesAdult check-in
- 2021-04-29
- 2021-05-04
- 2021-05-13
- 2021-05-20
- 2021-05-26
- 2021-07-20
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2021-10-21
Survey response — 6 months, dose 2MedDRA: Back disorder, Osteoarthritis — Feeling: Good · 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: Back problems/ diagnosed osteoarthritisMedDRA releases: 2024-11 · check-in free text available
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2021-10-21
Report sent to call center — 6 months, dose 2Be 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)
- 2021-10-27
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2022-03-19
Dose 3 — Pfizer-BioNTechCo-administered: Shingles:Tetanus
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2022-04-20
Survey response — 12 months, dose 2MedDRA: Benign hydatidiform mole, Surgery — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: Molar pregnancy · Healthcare visit (other): Surgery x2 and ongoing bloodworkMedDRA releases: 2024-11 · check-in free text available
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2022-04-20
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
- 2022-04-21
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2022-05-01
Survey response — day 42, dose 3MedDRA: Benign hydatidiform mole — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: Molar pregnancyMedDRA releases: 2024-11 · check-in free text available
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2022-05-01
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2022-05-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-23 | Moderna | |
| 2 | 2021-04-20 | Moderna | |
| 3 | 2022-03-19 | Pfizer-BioNTech | Shingles:Tetanus |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-21 | Unsuccessful | |
| 2022-04-20 | Unsuccessful | |
| 2022-05-01 | Unsuccessful |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Chest spasm, unable to breathe for approx 10 seconds
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Arm numbness/tingling
Release 10 — 6 months, dose 2
Symptoms: Back problems/ diagnosed osteoarthritis
Release 11 — 12 months, dose 2
Release 11 — day 42, dose 3
Symptoms: Molar pregnancy
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 | Surgery | · | · | ✓ |
| SD | Back disorder | · | · | ✓ |
| SD | Benign hydatidiform mole | · | · | ✓ |
| SD | Osteoarthritis | · | · | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Respiratory arrest | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release