5L8-27304-66566
2 vaccinations
5 coded responses
10 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 554 / MN
- Registered
- 2021-01-03
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-01-02
Dose 1 — Moderna
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2021-01-03
Registered in v-safe
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2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Muscle or body aches, Nausea · Be unable to do your normal daily activitiesFree text: Dizziness/lightheadedness; all s/s occurred on 1/3 at approximately 0300-0900MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-04
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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2021-01-07
Survey response — days 1–6 daily, dose 1MedDRA: Parosmia — Feeling: GoodFree text: Altered sense of smellMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-08
- 2021-01-16
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2021-01-30
Dose 2 — Moderna
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2021-01-30
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Abdominal painAdult check-in
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2021-02-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-02
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2021-02-06
Survey response — day 7, dose 2MedDRA: Nausea, Vertigo — Feeling: Good · Be unable to do your normal daily activitiesFree text: Nausea and vertigo yesterday 2/5, no s/s todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-20
Survey response — day 21, dose 2MedDRA: Depression, Disturbance in attention, Fatigue, Feeling abnormal, Memory impairment, Nausea, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: Severe fatigue, inability to concentrate, brain fog, forgetfulness, depression like symptoms, intermittent nausea, poor efficacy of ADHD medication despite dosage adjustments per PMHNP · Healthcare visit (other): Mental health care provider for med adjustmentsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-20
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-13
Survey response — day 42, dose 2MedDRA: Dyspnoea, Fatigue, Headache, Nausea — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Varying symptoms with unpredictable onset. Nausea, headaches, sob, fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-24
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-02 | Moderna | |
| 2 | 2021-01-30 | Moderna |
Call center
2 call center cases
1 successful · 1 priority 2/3 (triaged and no follow up)
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Dizziness/lightheadedness; all s/s occurred on 1/3 at approximately 0300-0900
Systemic reaction (other): Altered sense of smell
Release 3 — day 7, dose 2
Systemic reaction (other): Nausea and vertigo yesterday 2/5, no s/s today
Release 4 — day 21, dose 2
Symptoms: Severe fatigue, inability to concentrate, brain fog, forgetfulness, depression like symptoms, intermittent nausea, poor efficacy of ADHD medication despite dosage adjustments per PMHNP
Healthcare visit (other): Mental health care provider for med adjustments
Release 5 — day 42, dose 2
Symptoms: Varying symptoms with unpredictable onset. Nausea, headaches, sob, fatigue
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 | Depression | ✓ | ✓ | ✓ |
| SD | Disturbance in attention | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Memory impairment | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Parosmia | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release