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5DT-13229-66142

2 vaccinations 6 coded responses 13 check-ins 6 free-text entries 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
773 / TX
Registered
2021-02-20
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-10
    Dose 1 — Moderna
  2. 2021-02-20
    Registered in v-safe
  3. 2021-02-20
    Health check-in — day 7, dose 1
    Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches
    Adult check-in
  4. 2021-02-25
    Survey response — day 14, dose 1
    MedDRA: Chills, Emotional distress — Feeling: Fair
    Free text: Chills, no temp. Hi distress
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-03
    Survey response — day 21, dose 1
    MedDRA: Chills, Contusion, Epistaxis, Erythema — Feeling: Good
    Free text: Nose bleeds, occ Chilis. Red arm now looks more like bruising
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-09
    Dose 2 — Moderna
  7. 2021-03-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain
    Adult check-in
  8. 2021-03-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea
    Adult check-in
  9. 2021-03-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain
    Adult check-in
  10. 2021-03-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Ear pain, Gingival pain, Mouth swelling, Oropharyngeal pain, Toothache — Feeling: Fair · Site: Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: My mouth is swollen and when I attempt to chew, painful around all the gums and teeth. Did not have this problem prior to 2nd Vacine. Also throat hurts and severe right ear pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  12. 2021-03-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Mouth swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Inside mouth still swollen
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-17
    Health check-in — day 7, dose 2
    Feeling: Fair · Site: Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain
    Adult check-in
  14. 2021-03-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-09-07
    Survey response — 6 months, dose 2
    MedDRA: Fatigue, Office visit, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Very tired and ache · Healthcare visit (other): Dr visit
    MedDRA releases: 2024-11 · check-in free text available
  16. 2021-09-07
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-09-10
    Call successful
    Does not wish to fill out VAERS report
  18. 2022-03-09
    Survey response — 12 months, dose 2
    MedDRA: Colonoscopy abnormal, Endoscopy abnormal, Oesophagitis, Rectal haemorrhage, Rectal prolapse — Feeling: Fair
    Free text: Esophageal inflammation & prolapsed rectal hemmorage. Had a colinoscopy & endoscopy a few weeks ago,
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-02-10Moderna
22021-03-09Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-25

Symptoms: Chills, no temp. Hi distress

Release 5 — day 21, dose 1

2021-03-03

Symptoms: Nose bleeds, occ Chilis. Red arm now looks more like bruising

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): My mouth is swollen and when I attempt to chew, painful around all the gums and teeth. Did not have this problem prior to 2nd Vacine. Also throat hurts and severe right ear pain

2021-03-15

Systemic reaction (other): Inside mouth still swollen

Release 9 — 6 months, dose 2

2021-09-07

Symptoms: Very tired and ache
Healthcare visit (other): Dr visit

Release 11 — 12 months, dose 2

2022-03-09

Symptoms: Esophageal inflammation & prolapsed rectal hemmorage. Had a colinoscopy & endoscopy a few weeks ago,

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 · · ✓
SDChills ✓ ✓ ✓
SDColonoscopy abnormal · · ✓
SDContusion ✓ ✓ ✓
SDEmotional distress ✓ ✓ ✓
SDEndoscopy abnormal · · ✓
SDEpistaxis ✓ ✓ ✓
SDErythema ✓ ✓ ✓
SDFatigue · · ✓
SDOesophagitis · · ✓
SDPain · · ✓
SDRectal haemorrhage · · ✓
SDRectal prolapse · · ✓
SROEar pain ✓ ✓ ✓
SROGingival pain ✓ ✓ ✓
SROMouth swelling ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROToothache ✓ ✓ ✓

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