6DK-83009-56390
1 vaccination
6 coded responses
7 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 786 / TX
- Registered
- 2021-08-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-08-01
Dose 1 — Moderna
-
2021-08-12
Registered in v-safe
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2021-08-12
Survey response — day 7, dose 1MedDRA: Neuralgia — Feeling: Good · Site: Pain · Headache, Muscle or body achesFree text: Nerve painMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-08-15
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2021-08-22
Survey response — day 21, dose 1MedDRA: Fatigue — Feeling: FairFree text: FatigueMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-29
Survey response — day 28, dose 1MedDRA: Head discomfort, Headache, Paraesthesia — Feeling: FairFree text: Headaches, head pressure, facial tinglingMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-11-02
Survey response — 3 months, dose 1MedDRA: Adverse reaction, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Had COVID, first day of symptoms October 19, 2021. Had 2 positive COVID tests.MedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Report sent to call center — 3 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-11-03
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2021-11-03
Call successfulReported to VAERS voluntarily prior to GDIT contact
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2022-01-31
Survey response — 6 months, dose 1MedDRA: COVID-19, Electric shock sensation, Gait disturbance, Hypoaesthesia, Movement disorder, Muscle spasms, Paraesthesia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Had body jolts and brain zaps after vaccine. Post COVID they became severe and frequent. Whole body would spasm, and I had trouble walking, and controlling body. Resolved after 2 weeks. Still having numbness & tingling in feet and toes.MedDRA releases: 2024-11 · check-in free text available
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2022-08-01
Survey response — 12 months, dose 1MedDRA: Fatigue, Headache, Hypotension, Nerve injury, Nervous system disorder, Neuralgia, Palpitations, Supraventricular extrasystoles, Temperature intolerance — Feeling: FairFree text: Diagnosed with cardiac PAC's and palpitations Episodes of low blood pressure Neurological issues and nerve damage (most have since resolved) Occasional left side headaches & nerve pain in middle back Heat sensitivity and brief episodes of fatigueMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-01 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 9 — day 7, dose 1
Systemic reaction (other): Nerve pain
Release 9 — day 21, dose 1
Symptoms: Fatigue
Release 9 — day 28, dose 1
Symptoms: Headaches, head pressure, facial tingling
Release 10 — 3 months, dose 1
Symptoms: Had COVID, first day of symptoms October 19, 2021. Had 2 positive COVID tests.
Release 11 — 6 months, dose 1
Symptoms: Had body jolts and brain zaps after vaccine. Post COVID they became severe and frequent. Whole body would spasm, and I had trouble walking, and controlling body. Resolved after 2 weeks. Still having numbness & tingling in feet and toes.
Release 12 — 12 months, dose 1
Symptoms: Diagnosed with cardiac PAC's and palpitations Episodes of low blood pressure Neurological issues and nerve damage (most have since resolved) Occasional left side headaches & nerve pain in middle back Heat sensitivity and brief episodes of 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 |
|---|---|---|---|---|
| SD | Adverse reaction | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Electric shock sensation | · | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Gait disturbance | · | · | ✓ |
| SD | Head discomfort | ✓ | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Hypoaesthesia | · | · | ✓ |
| SD | Hypotension | · | · | ✓ |
| SD | Movement disorder | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Nerve injury | · | · | ✓ |
| SD | Nervous system disorder | · | · | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Paraesthesia | ✓ | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Supraventricular extrasystoles | · | · | ✓ |
| SD | Temperature intolerance | · | · | ✓ |
| SRO | Neuralgia | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release