62X-21930-32279
3 vaccinations
13 coded responses
39 check-ins
13 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 142 / NY
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-30
Registered in v-safe
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2021-01-30
Dose 1 — Moderna
- 2021-01-30
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-13
- 2021-02-20
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2021-02-27
Dose 2 — Moderna
- 2021-02-27
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2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Hyperhidrosis, Nasopharyngitis, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Sweating cold shakingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-02
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2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Cough — Feeling: GoodFree text: CoughingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy, Tenderness — Feeling: GoodFree text: Tenderness shot arm armpit. Swollen lymph node? Probably started day after shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Survey response — days 1–6 daily, dose 2MedDRA: Cough — Feeling: GoodFree text: Cough phlegmMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Survey response — day 7, dose 2MedDRA: Cough, Productive cough — Feeling: GoodFree text: Cough phlegmMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-15
- 2021-03-20
- 2021-03-28
- 2021-04-03
- 2021-04-10
- 2021-05-29
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2021-08-29
Survey response — 6 months, dose 2MedDRA: Inflammation, Office visit, Plantar fasciitis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: March 2021 just after 2nd shot developed severe planter fasciitis in left foot. No obvious cause other than inflammation caused by Moderna. · Healthcare visit (other): Primary Care and Podiatrist visitsMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-29
Report sent to call center — 6 months, 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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2021-10-30
Dose 3 — Moderna
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2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Decreased appetite, Fatigue, Mobility decreased, Nasopharyngitis, Pyrexia, Somnolence, Thirst, Tremor — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Severe shaking, very cold, high fever last 20 hour, fatigue, in bed 15 hours, dozed occasionally, no food just liquids, very thirsty.MedDRA releases: 2024-11 · check-in free text available
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2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Feeling abnormal, Pyrexia — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Fever 100-101.3 10pm Saturday to 10pm Sunday. Bad 24 hours. No friends or relatives experienced this. Same misery as shot #2MedDRA releases: 2024-11 · check-in free text available
- 2021-11-02
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2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Poor peripheral circulation, Skin discolouration — Feeling: Good · Site: PainFree text: Noticed poor circulation and discoloration in toes the last two daysMedDRA releases: 2024-11 · check-in free text available
- 2021-11-04
- 2021-11-05
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2021-11-06
Survey response — day 7, dose 3MedDRA: Unevaluable event — Feeling: GoodFree text: Not looking forward to the fourth shotMedDRA releases: 2024-11 · check-in free text available
- 2021-11-13
- 2021-11-20
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2021-11-27
Survey response — day 28, dose 3MedDRA: Abdominal pain lower — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Pain lower right abdomen.MedDRA releases: 2024-11 · check-in free text available
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2021-12-04
Survey response — day 35, dose 3MedDRA: Herpes zoster, Pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Very painful Shingles attack. Probably triggered by Moderna third booster shot.MedDRA releases: 2024-11 · check-in free text available
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2021-12-04
Report sent to call center — day 35, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-12-06
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-11
- 2022-01-29
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2022-05-02
Survey response — 6 months, dose 3MedDRA: Eczema — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Developed eczema for the first time ever. Suspect this is a result of damage to my immune system by the Covid vaccine.MedDRA releases: 2024-11 · check-in free text available
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2022-05-02
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-05-03
Call successfulParticipant prefers to complete VAERS report online
- 2022-10-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna | |
| 2 | 2021-02-27 | Moderna | |
| 3 | 2021-10-30 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Sweating cold shaking
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Coughing
Systemic reaction (other): Tenderness shot arm armpit. Swollen lymph node? Probably started day after shot.
Systemic reaction (other): Cough phlegm
Release 5 — day 7, dose 2
Systemic reaction (other): Cough phlegm
Release 9 — 6 months, dose 2
Symptoms: March 2021 just after 2nd shot developed severe planter fasciitis in left foot. No obvious cause other than inflammation caused by Moderna.
Healthcare visit (other): Primary Care and Podiatrist visits
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Severe shaking, very cold, high fever last 20 hour, fatigue, in bed 15 hours, dozed occasionally, no food just liquids, very thirsty.
Systemic reaction (other): Fever 100-101.3 10pm Saturday to 10pm Sunday. Bad 24 hours. No friends or relatives experienced this. Same misery as shot #2
Systemic reaction (other): Noticed poor circulation and discoloration in toes the last two days
Release 10 — day 7, dose 3
Systemic reaction (other): Not looking forward to the fourth shot
Release 10 — day 28, dose 3
Symptoms: Pain lower right abdomen.
Release 10 — day 35, dose 3
Symptoms: Very painful Shingles attack. Probably triggered by Moderna third booster shot.
Release 11 — 6 months, dose 3
Symptoms: Developed eczema for the first time ever. Suspect this is a result of damage to my immune system by the Covid vaccine.
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 | Abdominal pain lower | · | · | ✓ |
| SD | Eczema | · | · | ✓ |
| SD | Herpes zoster | · | · | ✓ |
| SD | Inflammation | ✓ | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Plantar fasciitis | ✓ | · | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Feeling abnormal | · | · | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Mobility decreased | · | · | ✓ |
| SRO | Nasopharyngitis | ✓ | ✓ | ✓ |
| SRO | Poor peripheral circulation | · | · | ✓ |
| SRO | Productive cough | ✓ | ✓ | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Skin discolouration | · | · | ✓ |
| SRO | Somnolence | · | · | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
| SRO | Thirst | · | · | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release