59F-15657-28191
4 vaccinations
9 coded responses
43 check-ins
9 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 857 / AZ
- Registered
- 2021-02-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-13
Dose 1 — Moderna
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2021-02-14
Registered in v-safe
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2021-02-14
Survey response — days 1–6 daily, dose 1MedDRA: Dysgeusia — Feeling: Good · Site: ItchingFree text: About an hour after shot I had a metallic taste in my mouth. It went away and this morning after breakfast it happened again. Lasted about 25 minutes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-15
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-27
- 2021-03-06
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2021-03-13
Dose 2 — Moderna
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2021-03-13
Survey response — day 0, dose 2MedDRA: Dizziness, Dysgeusia, Fatigue, Headache, Hypertension, Immediate post-injection reaction, Medical counselling — Feeling: Fair · Site: Pain · Headache, NauseaFree text: Right after the shot I got very dizzy and felt like I might pass out. It scared me . They took my blood pressure and it was high. The doc released me when it started dropping. I feel much better now slight headache ach and tired. I also got that metallic taste in my mouth for a short time.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-03-15
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2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-06-12
- 2021-09-11
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2021-10-22
Dose 3 — Moderna
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2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tirednessAdult check-in
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2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Ear pain — Feeling: Fair · Site: Itching · Fatigue or tirednessFree text: Tooth ache?left side and ear ache right side. Could be sinus infection which I get every year about this time,MedDRA releases: 2024-11 · check-in free text available
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2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Office visit, Tooth infection — Feeling: Fair · Site: Itching · Headache, Fatigue or tirednessFree text: I went to dentist and have a tooth infection. They started me on penicillin for a week and I have to go Monday to get root canal re done.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-29
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2021-11-05
Survey response — day 14, dose 3MedDRA: Back pain, Nephrolithiasis — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Back pain, kidney stoneMedDRA releases: 2024-11 · check-in free text available
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2021-11-05
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
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2021-11-09
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-12
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2021-11-19
Survey response — day 28, dose 3MedDRA: Office visit, Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: UTI · Healthcare visit (other): Doctors officeMedDRA releases: 2024-11 · check-in free text available
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2021-11-19
Report sent to call center — day 28, dose 3Get care from a doctor or other healthcare professional1 call case(s)
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2021-11-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-26
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2021-12-03
Survey response — day 42, dose 3MedDRA: Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: UtiMedDRA releases: 2024-11 · check-in free text available
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2021-12-03
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2021-12-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-21
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2022-04-06
Dose 4 — Moderna
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2022-04-15
Survey response — day 7, dose 4MedDRA: Lymphadenopathy, Mammogram abnormal — Feeling: Good · Headache, Joint pains, Fatigue or tirednessFree text: I had a mama gram 2 days after booster and I have to go back as they found swollen node on left side the sams as shot, I go for a so a gram on May 9MedDRA releases: 2024-11 · check-in free text available
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2022-04-20
Survey response — day 14, dose 4MedDRA: Lymphadenopathy, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Swollen lymph on side I got shor · Healthcare visit (other): Going for sona gram May 9MedDRA releases: 2024-11 · check-in free text available
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2022-04-20
Report sent to call center — day 14, dose 4Get care from a doctor or other healthcare professional1 call case(s)
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2022-04-22
Call successfulDoes not wish to fill out VAERS report
- 2022-04-27
- 2022-05-06
- 2022-05-11
- 2022-05-20
- 2022-07-06
- 2022-10-05
- 2023-04-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-13 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-04-06 | Moderna | No |
Call center
4 call center cases
4 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): About an hour after shot I had a metallic taste in my mouth. It went away and this morning after breakfast it happened again. Lasted about 25 minutes.
Release 5 — day 0, dose 2
Systemic reaction (other): Right after the shot I got very dizzy and felt like I might pass out. It scared me . They took my blood pressure and it was high. The doc released me when it started dropping. I feel much better now slight headache ach and tired. I also got that metallic taste in my mouth for a short time.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Tooth ache?left side and ear ache right side. Could be sinus infection which I get every year about this time,
Systemic reaction (other): I went to dentist and have a tooth infection. They started me on penicillin for a week and I have to go Monday to get root canal re done.
Release 10 — day 14, dose 3
Symptoms: Back pain, kidney stone
Release 10 — day 28, dose 3
Release 10 — day 42, dose 3
Symptoms: Uti
Release 11 — day 7, dose 4
Systemic reaction (other): I had a mama gram 2 days after booster and I have to go back as they found swollen node on left side the sams as shot, I go for a so a gram on May 9
Release 11 — day 14, dose 4
Symptoms: Swollen lymph on side I got shor
Healthcare visit (other): Going for sona gram May 9
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 | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Lymphadenopathy | · | · | ✓ |
| SD | Nephrolithiasis | · | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hypertension | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Mammogram abnormal | · | · | ✓ |
| SRO | Medical counselling | ✓ | ✓ | ✓ |
| SRO | Office visit | · | · | ✓ |
| SRO | Tooth infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release