6BN-25185-29114
3 vaccinations
7 coded responses
32 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 985 / WA
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-18
Registered in v-safe
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2021-02-18
Dose 1 — Moderna
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2021-02-18
Survey response — day 0, dose 1MedDRA: No adverse event — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-19
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: Pain · ChillsFree text: No.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
-
2021-02-25
Survey response — day 7, dose 1MedDRA: Asthenia, Fatigue — Feeling: Good · Fatigue or tirednessFree text: The tiredness seems to come and go. One day Im fine, the next I might want to take a nap or I just dont have energy for anything. I feel fine overall. This tiredness just kind of hits randomly it seems like.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-11
- 2021-03-18
-
2021-03-22
Dose 2 — Moderna
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2021-04-01
Survey response — day 7, dose 2MedDRA: Feeling abnormal — Feeling: Good · Site: Pain, Redness, Itching · Be unable to do your normal daily activitiesFree text: Had most of the listed symptoms listed above the day after shot and throughout the week. Also a kind of brain fog which was odd.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-09-20
-
2021-10-25
Dose 3 — ModernaCo-administered: Flu
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2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend schoolAdult check-in
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
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2022-04-25
Survey response — 6 months, dose 3MedDRA: Cardiac disorder, Chills, Dizziness, Headache, Insomnia, Pain, Pneumonia — 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 · Emergency room or emergency department visitFree text: Pneumonia, congestive heart, dizziness, loss of sleep, headache, body aches, severe chills.MedDRA releases: 2024-11 · check-in free text available
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2022-04-25
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
- 2022-04-26
-
2022-04-28
Call successfulDoes not wish to fill out VAERS report
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2022-10-25
Survey response — 12 months, dose 3MedDRA: Asthenia, Disorientation, Intensive care, Intestinal haemorrhage, Office visit, Transfusion — 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 · Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Intestinal bleeding. Severe. Was in ICU and needed several pints of blood. Got home last night. Very weak, disoriented. · Healthcare visit (other): ICU Critical Care.MedDRA releases: 2024-11 · check-in free text available
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2022-10-25
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-10-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-18 | Moderna | |
| 2 | 2021-03-22 | Moderna | |
| 3 | 2021-10-25 | Moderna | Flu |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): No
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): No.
Release 4 — day 7, dose 1
Systemic reaction (other): The tiredness seems to come and go. One day Im fine, the next I might want to take a nap or I just dont have energy for anything. I feel fine overall. This tiredness just kind of hits randomly it seems like.
Release 6 — day 7, dose 2
Systemic reaction (other): Had most of the listed symptoms listed above the day after shot and throughout the week. Also a kind of brain fog which was odd.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): No
Release 11 — 6 months, dose 3
Symptoms: Pneumonia, congestive heart, dizziness, loss of sleep, headache, body aches, severe chills.
Release 12 — 12 months, dose 3
Symptoms: Intestinal bleeding. Severe. Was in ICU and needed several pints of blood. Got home last night. Very weak, disoriented.
Healthcare visit (other): ICU Critical Care.
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 | Intensive care | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Cardiac disorder | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Disorientation | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Intensive care | · | · | ✓ |
| SD | Intestinal haemorrhage | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Transfusion | · | · | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release