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5XS-18534-33398

2 vaccinations 4 coded responses 4 check-ins 4 free-text entries 4 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
920 / CA
Registered
2021-04-08
Relationship
Self
Race
White
Ethnicity
N/A

Timeline

  1. 2021-02-01
    Dose 1 — Moderna
  2. 2021-02-28
    Dose 2 — Moderna
  3. 2021-04-08
    Registered in v-safe
  4. 2021-04-08
    Survey response — day 35, dose 2
    MedDRA: Cardiac disorder, Lymphadenopathy, Medical counselling, Mobility decreased, Myalgia — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms: MASSIVE HYPERINFLAMMATORY RESPONSE. Could not do stairs, had to move back downstairs, heart issues - enormously swollen lymph nodes, muscle pain, unable to even walk around the block or lift 2 pounds. · Healthcare visit (other): Also I saw a cardiologist and an ENT
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-08
    Report sent to call center — day 35, dose 2
    Be unable to work · Get care from a doctor or other healthcare professional
    1 call case(s)
  6. 2021-04-16
    Survey response — day 42, dose 2
    MedDRA: Asthenia, Cardiac disorder, Emergency care, Office visit, Specialist consultation — Feeling: Poor · Be unable to work, 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 visit
    Free text: Symptoms: Heart problems. Was too weak right after vaccine to even do a stress test - going back next week for · Healthcare visit (other): saw an ENT and cardiologist and went to urgent care
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-16
    Report sent to call center — day 42, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  8. 2021-05-30
    Survey response — 3 months, dose 2
    MedDRA: Inflammation, Office visit, Oral mucosal blistering, Pericarditis, Skin exfoliation — 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
    Free text: Symptoms: Pericarditis, sinus inflammation, mouth blisters, peeling hands and feet · Healthcare visit (other): I had someone drive me to the Cardiologist and ENT
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-05-30
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-08-29
    Survey response — 6 months, dose 2
    MedDRA: Arthralgia, Brain fog, Facial paralysis, Fatigue, Inflammatory bowel disease, Malaise, Mouth ulceration, Myalgia, Nodule, Oral candidiasis, Oral disorder, Pericarditis, Skin exfoliation, Tongue discomfort, Trichoglossia, Unevaluable event — Feeling: Poor · Be unable to work or attend school, 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 visit, Emergency room or emergency department visit
    Free text: Pericarditis, oral thrush, mouth ulcers, burning tongue, facial distortion, lumps on face and in mouth, brain fog, fatigue, malaise, hairy tongue, muscle/joint pain. Skin growth/peeling on hands and feet. IBD
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  11. 2021-08-29
    Report sent to call center — 6 months, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    1 call case(s)
  12. 2021-10-07
  13. 2021-10-11

Vaccinations

DoseDateManufacturerCo-administered
12021-02-01Moderna
22021-02-28Moderna

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 7 — day 35, dose 2

2021-04-08

Symptoms: MASSIVE HYPERINFLAMMATORY RESPONSE. Could not do stairs, had to move back downstairs, heart issues - enormously swollen lymph nodes, muscle pain, unable to even walk around the block or lift 2 pounds.
Healthcare visit (other): Also I saw a cardiologist and an ENT

Release 7 — day 42, dose 2

2021-04-16

Symptoms: Heart problems. Was too weak right after vaccine to even do a stress test - going back next week for
Healthcare visit (other): saw an ENT and cardiologist and went to urgent care

Release 8 — 3 months, dose 2

2021-05-30

Symptoms: Pericarditis, sinus inflammation, mouth blisters, peeling hands and feet
Healthcare visit (other): I had someone drive me to the Cardiologist and ENT

Release 9 — 6 months, dose 2

2021-08-29

Symptoms: Pericarditis, oral thrush, mouth ulcers, burning tongue, facial distortion, lumps on face and in mouth, brain fog, fatigue, malaise, hairy tongue, muscle/joint pain. Skin growth/peeling on hands and feet. IBD

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
HCVOEmergency care ✓ ✓ ✓
HCVOMedical counselling ✓ ✓ ✓
HCVOOffice visit ✓ ✓ ✓
HCVOSpecialist consultation ✓ ✓ ✓
SDArthralgia ✓ · ✓
SDAsthenia ✓ ✓ ✓
SDBrain fog ✓ · ✓
SDCardiac disorder ✓ ✓ ✓
SDFacial paralysis ✓ · ✓
SDFatigue ✓ · ✓
SDInflammation ✓ ✓ ✓
SDInflammatory bowel disease ✓ · ✓
SDLymphadenopathy ✓ ✓ ✓
SDMalaise ✓ · ✓
SDMobility decreased ✓ ✓ ✓
SDMouth ulceration ✓ · ✓
SDMyalgia ✓ ✓ ✓
SDNodule ✓ · ✓
SDOral candidiasis ✓ · ✓
SDOral disorder ✓ · ✓
SDOral mucosal blistering ✓ ✓ ✓
SDPericarditis ✓ ✓ ✓
SDSkin exfoliation ✓ ✓ ✓
SDTongue discomfort ✓ · ✓
SDTrichoglossia ✓ · ✓
SDUnevaluable event ✓ · ✓

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