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
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2021-02-10
Dose 1 — Moderna
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2021-02-20
Registered in v-safe
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2021-02-20
Health check-in — day 7, dose 1Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body achesAdult check-in
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2021-02-25
Survey response — day 14, dose 1MedDRA: Chills, Emotional distress — Feeling: FairFree text: Chills, no temp. Hi distressMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — day 21, dose 1MedDRA: Chills, Contusion, Epistaxis, Erythema — Feeling: GoodFree text: Nose bleeds, occ Chilis. Red arm now looks more like bruisingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-09
Dose 2 — Moderna
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2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal painAdult check-in
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2021-03-11
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, DiarrheaAdult check-in
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2021-03-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
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2021-03-13
Survey response — days 1–6 daily, dose 2MedDRA: 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 tirednessFree 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 painMedDRA 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: Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-15
Survey response — days 1–6 daily, dose 2MedDRA: Mouth swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Inside mouth still swollenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Health check-in — day 7, dose 2Feeling: Fair · Site: Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-03-23
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2021-09-07
Survey response — 6 months, dose 2MedDRA: Fatigue, Office visit, Pain — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Very tired and ache · Healthcare visit (other): Dr visitMedDRA releases: 2024-11 · check-in free text available
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2021-09-07
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-09-10
Call successfulDoes not wish to fill out VAERS report
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2022-03-09
Survey response — 12 months, dose 2MedDRA: Colonoscopy abnormal, Endoscopy abnormal, Oesophagitis, Rectal haemorrhage, Rectal prolapse — Feeling: FairFree text: Esophageal inflammation & prolapsed rectal hemmorage. Had a colinoscopy & endoscopy a few weeks ago,MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | |
| 2 | 2021-03-09 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 4 — day 14, dose 1
Symptoms: Chills, no temp. Hi distress
Release 5 — day 21, dose 1
Symptoms: Nose bleeds, occ Chilis. Red arm now looks more like bruising
Release 5 — days 1–6 daily, dose 2
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
Systemic reaction (other): Inside mouth still swollen
Release 9 — 6 months, dose 2
Release 11 — 12 months, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Colonoscopy abnormal | · | · | ✓ |
| SD | Contusion | ✓ | ✓ | ✓ |
| SD | Emotional distress | ✓ | ✓ | ✓ |
| SD | Endoscopy abnormal | · | · | ✓ |
| SD | Epistaxis | ✓ | ✓ | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Oesophagitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Rectal haemorrhage | · | · | ✓ |
| SD | Rectal prolapse | · | · | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Gingival pain | ✓ | ✓ | ✓ |
| SRO | Mouth swelling | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Toothache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release