6BT-16994-72471
5 vaccinations
12 coded responses
48 check-ins
11 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 225 / VA
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-03
Registered in v-safe
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2021-02-03
Dose 1 — Moderna
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2021-02-03
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-05
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-02-07
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
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2021-03-03
Dose 2 — Moderna
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2021-03-03
Health check-in — day 0, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body achesAdult check-in
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2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-10
Health check-in — day 7, dose 2Feeling: Good · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-17
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2021-03-24
Survey response — day 21, dose 2MedDRA: Dizziness, Nausea, Rhinorrhoea, Vertigo — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Dizziness, vertigo, nausea and a very runny nose.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-31
Survey response — day 28, dose 2MedDRA: Blood pressure increased, Breast cancer, Cerebral disorder, Medical counselling, Stress — Feeling: GoodFree text: Blood pressure became elevated to 141/90.Usually B/P has been 120/76.Called PCP who ordered Triamterene 75/50 to be taken daily.Think elevated pressure is due to stress and concern regarding critically ill daughter, Stage 4 Breast and Brain Ca.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
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2021-04-14
Survey response — day 42, dose 2MedDRA: Blood pressure increased, Office visit, Stress — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Elevated B\P at echocardiogram 178/110, pcp put back on meds, cardiologist said its stress from worry about sick daughter, she is 46 yrs, Dx stage 4, Brain & breast cancer, please pray 4 my sweet daughter. · Healthcare visit (other): Office VisitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professionalno matching call case
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2021-06-02
Survey response — 3 months, dose 2MedDRA: Cystocele, Pre-existing disease — Feeling: Fair · 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: Had prolapsed bladder 25 years ago, When repaired , Doc told me it would last 10 yrs, so not 2 surprised, scheduled for corrective and other surgeries June 7th,MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-02
Report sent to call center — 3 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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2021-09-02
Survey response — 6 months, dose 2MedDRA: Deafness, Dizziness, Nausea, Pre-existing disease, Rectocele repair, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Had surgery on 7/22 for repair of rectocele, which came very suddenly.On 8/31/21 developed dizziness, nausea from long standing ear condition, which is causing loss of hearing. · Healthcare visit (other): Has same day surgery on 7/22/21MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-02
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)
- 2021-09-07
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2021-10-22
Dose 3 — Moderna
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2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-10-29
Health check-in — day 7, dose 3Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-11-05
Survey response — day 14, dose 3MedDRA: Diarrhoea — Feeling: GoodFree text: Terrible watery diarrhea, must be something that I ate, as it subsided the next day.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-12
- 2021-11-19
- 2021-11-27
- 2021-12-03
- 2022-01-21
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2022-04-01
Dose 4 — ModernaCo-administered: Shingles
- 2022-04-22
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2022-05-01
Survey response — day 28, dose 4MedDRA: Blood pressure decreased, Hypoaesthesia, Office visit, Paraesthesia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Lately I have had a decrease in my B/P accompanied by numbness and tingling in my fingertips and in some toes, my Doctor is currently evaluating these new symptoms.MedDRA releases: 2024-11 · check-in free text available
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2022-05-01
Report sent to call center — day 28, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-04
- 2022-05-06
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2022-05-06
Call successfulCompleted over the phone
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2022-05-08
Survey response — day 35, dose 4MedDRA: Blood pressure decreased, Hypoaesthesia, Paraesthesia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: I have developed numbness and tingling in the finger tips of both hands and feet as well as a drop in my blood pressure to 110/70. Reported to V Safe, (b)(6)MedDRA releases: 2024-11 · check-in free text available
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2022-05-08
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-10
- 2022-05-10
- 2022-05-10
- 2022-05-10
- 2022-05-13
- 2022-07-01
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2022-09-21
Dose 5 — Pfizer-BioNTechCo-administered: Flu
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2022-09-22
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-09-23
Survey response — days 1–6 daily, dose 5MedDRA: Rhinorrhoea — Feeling: Good · Site: Pain, Swelling · Fever · Joint pains, Fatigue or tirednessFree text: Persistent runny noseMedDRA releases: 2024-11 · check-in free text available
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2022-09-26
Survey response — days 1–6 daily, dose 5MedDRA: Rhinorrhoea — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Runny NoseMedDRA releases: 2024-11 · check-in free text available
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2022-09-30
Survey response — day 7, dose 5MedDRA: Rhinorrhoea — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Still have. Runny Nose, no cold S/SMedDRA releases: 2024-11 · check-in free text available
- 2022-10-05
- 2022-10-13
- 2022-10-20
- 2022-10-26
- 2022-11-04
- 2022-12-21
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2023-03-23
Survey response — 6 months, dose 5MedDRA: Hypertension, Neuropathy peripheral, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-03-23
Report sent to call center — 6 months, dose 5Be 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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2023-03-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2023-03-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-04-01 | Moderna | Shingles |
| 5 | 2022-09-21 | Pfizer-BioNTech | Flu |
Call center
5 call center cases
5 successful
VAERS report filed, before or during a call: 3
1 wait over 3 months for a first call
1 check-in flagged for a call with no call center case on record
Free text
Release 6 — day 21, dose 2
Symptoms: Dizziness, vertigo, nausea and a very runny nose.
Release 6 — day 28, dose 2
Symptoms: Blood pressure became elevated to 141/90.Usually B/P has been 120/76.Called PCP who ordered Triamterene 75/50 to be taken daily.Think elevated pressure is due to stress and concern regarding critically ill daughter, Stage 4 Breast and Brain Ca.
Release 7 — day 42, dose 2
Symptoms: Elevated B\P at echocardiogram 178/110, pcp put back on meds, cardiologist said its stress from worry about sick daughter, she is 46 yrs, Dx stage 4, Brain & breast cancer, please pray 4 my sweet daughter.
Healthcare visit (other): Office Visit
Release 8 — 3 months, dose 2
Symptoms: Had prolapsed bladder 25 years ago, When repaired , Doc told me it would last 10 yrs, so not 2 surprised, scheduled for corrective and other surgeries June 7th,
Release 9 — 6 months, dose 2
Symptoms: Had surgery on 7/22 for repair of rectocele, which came very suddenly.On 8/31/21 developed dizziness, nausea from long standing ear condition, which is causing loss of hearing.
Healthcare visit (other): Has same day surgery on 7/22/21
Release 10 — day 14, dose 3
Symptoms: Terrible watery diarrhea, must be something that I ate, as it subsided the next day.
Release 11 — day 28, dose 4
Symptoms: Lately I have had a decrease in my B/P accompanied by numbness and tingling in my fingertips and in some toes, my Doctor is currently evaluating these new symptoms.
Release 11 — day 35, dose 4
Symptoms: I have developed numbness and tingling in the finger tips of both hands and feet as well as a drop in my blood pressure to 110/70. Reported to V Safe, (b)(6)
redacted (b)(6)
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Persistent runny nose
Systemic reaction (other): Runny Nose
Release 12 — day 7, dose 5
Systemic reaction (other): Still have. Runny Nose, no cold S/S
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 | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ✓ | · | ✓ |
| SD | Blood pressure decreased | · | · | ✓ |
| SD | Blood pressure increased | ✓ | ✓ | ✓ |
| SD | Breast cancer | ○ | ✓ | ○ |
| SD | Cerebral disorder | ○ | ✓ | ○ |
| SD | Cystocele | ✓ | ✓ | ✓ |
| SD | Deafness | ✓ | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Hypoaesthesia | · | · | ✓ |
| SD | Medical counselling | ✓ | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Neuropathy peripheral | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Rectocele repair | ✓ | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Stress | ✓ | ✓ | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release