5KV-12829-09987
5 vaccinations
6 coded responses
43 check-ins
6 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 010 / MA
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
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2021-01-12
Dose 1 — Moderna
- 2021-01-12
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2021-01-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Chills, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-01-13
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2021-01-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-01-15
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2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-01-16
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-26
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2021-02-02
Survey response — day 21, dose 1MedDRA: Fatigue, Nausea — Feeling: Good · Be unable to do your normal daily activitiesFree text: Nausea and fatigue for 1 dayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
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2021-02-11
Dose 2 — Moderna
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2021-02-11
Health check-in — day 0, dose 2Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Palpitations — Feeling: Poor · Site: Itching · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Occasional feelings of heart racingMedDRA 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 2Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-02-16
Survey response — days 1–6 daily, dose 2MedDRA: Ageusia, Chest discomfort, Gastrointestinal disorder, Malaise, Respiratory symptom — Feeling: Good · Fatigue or tirednessFree text: Felt much more sick after first vaccine. Always have thought I had mild case of COVID In February 2020. GI problems & loss of taste , followed by respiratory symptoms including feeling like a belt was being tightened around my chest.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-02-18
- 2021-02-27
- 2021-03-05
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-05-13
- 2021-08-12
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2021-11-12
Dose 3 — Moderna
- 2022-02-11
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2022-04-20
Dose 4 — Moderna
- 2022-04-28
- 2022-05-04
- 2022-05-18
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2022-05-26
Survey response — day 35, dose 4MedDRA: Erythema, Exposure to SARS-CoV-2, Office visit, Peripheral swelling, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Experienced possible COVID toes post COVID exposure at daughters wedding 5/14. Was exposed to COVID at wedding but tested negative on 5/20 & 5/22. No other symptoms. Did take day off work 5/20 saw MD for red swollen toes. Swollen toes resolved 1 wk · Healthcare visit (other): Red swollen toes post COVID exposureMedDRA releases: 2024-11 · check-in free text available
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2022-05-26
Report sent to call center — day 35, dose 4Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-27
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2022-06-01
Survey response — day 42, dose 4MedDRA: Erythema, Exposure to SARS-CoV-2, Office visit, Peripheral swelling, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: After COVID exposure at 5/14 wedding, Red swollen toes on right foot 5/18, saw MD 5/20, took day off from work 5/20, tested neg for COVID 5/19 , 5/20 & 5/22. Red swollen toes resolved themselves.MedDRA releases: 2024-11 · check-in free text available
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2022-06-01
Report sent to call center — day 42, dose 4Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-06-01
Call successfulParticipant prefers to complete VAERS report online
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2022-06-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-07-20
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2022-10-21
Survey response — 6 months, dose 4MedDRA: Cardiac murmur, Echocardiogram abnormal, Mitral valve incompetence, Presyncope — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Mitral valve regurgitation found during recent echocardiogram Was tested due to heart murmur and episode of presyncope.MedDRA releases: 2024-11 · check-in free text available
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2022-10-21
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-10-24
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2022-11-06
Dose 5 — Moderna
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2022-11-08
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
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2022-11-09
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-11-10
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2022-11-15
- 2022-11-22
- 2022-11-28
- 2022-12-05
- 2022-12-11
- 2022-12-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
| 5 | 2022-11-06 | Moderna | No |
Call center
5 call center cases
2 successful · 1 unsuccessful · 2 priority 2/3 (triaged and no follow up)
Free text
Release 3 — day 21, dose 1
Symptoms: Nausea and fatigue for 1 day
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Occasional feelings of heart racing
Systemic reaction (other): Felt much more sick after first vaccine. Always have thought I had mild case of COVID In February 2020. GI problems & loss of taste , followed by respiratory symptoms including feeling like a belt was being tightened around my chest.
Release 11 — day 35, dose 4
Symptoms: Experienced possible COVID toes post COVID exposure at daughters wedding 5/14. Was exposed to COVID at wedding but tested negative on 5/20 & 5/22. No other symptoms. Did take day off work 5/20 saw MD for red swollen toes. Swollen toes resolved 1 wk cut off by CDC
Healthcare visit (other): Red swollen toes post COVID exposure
Release 11 — day 42, dose 4
Symptoms: After COVID exposure at 5/14 wedding, Red swollen toes on right foot 5/18, saw MD 5/20, took day off from work 5/20, tested neg for COVID 5/19 , 5/20 & 5/22. Red swollen toes resolved themselves.
Release 12 — 6 months, dose 4
Symptoms: Mitral valve regurgitation found during recent echocardiogram Was tested due to heart murmur and episode of presyncope.
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 | Erythema | · | · | ✓ |
| HCVO | Exposure to SARS-CoV-2 | · | · | ✓ |
| HCVO | Peripheral swelling | · | · | ✓ |
| SD | Cardiac murmur | · | · | ✓ |
| SD | Echocardiogram abnormal | · | · | ✓ |
| SD | Erythema | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Mitral valve incompetence | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Presyncope | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Ageusia | ✓ | ✓ | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Respiratory symptom | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release