6JH-13435-57107
4 vaccinations
13 coded responses
46 check-ins
13 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 211 / MD
- Registered
- 2021-05-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-01
Registered in v-safe
-
2021-05-01
Dose 1 — Moderna
- 2021-05-01
-
2021-05-02
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Site: Pain · Fever · Chills, DiarrheaFree text: Sniffles, runny nose, mild sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-03
Survey response — days 1–6 daily, dose 1MedDRA: Cough — Feeling: Fair · Site: Pain · Fever · ChillsFree text: CoughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-04
Survey response — days 1–6 daily, dose 1MedDRA: Night sweats — Feeling: Fair · Fever · ChillsFree text: Night sweats (last night)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-05
- 2021-05-06
- 2021-05-07
- 2021-05-08
-
2021-05-15
Survey response — day 14, dose 1MedDRA: Chills — Feeling: FairFree text: ChillsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-22
-
2021-05-29
Dose 2 — Moderna
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2021-05-29
Survey response — day 0, dose 2MedDRA: Back pain, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Fever · HeadacheFree text: Back ache, sniffles, soar throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-30
Survey response — days 1–6 daily, dose 2MedDRA: Cough, Oropharyngeal pain — Feeling: Fair · Site: Pain · Fever · Chills, HeadacheFree text: Slight cough and soar throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-01
-
2021-06-02
Survey response — days 1–6 daily, dose 2MedDRA: Cough — Feeling: Fair · Fever · Chills, Muscle or body achesFree text: Irritating coughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-03
Survey response — days 1–6 daily, dose 2MedDRA: Cough, Dyspnoea, Rhinorrhoea — Feeling: Fair · Fever · Chills, DiarrheaFree text: Cough, sniffles popover shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint painsAdult check-in
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2021-06-05
Survey response — day 7, dose 2MedDRA: Cough, Dyspnoea — Feeling: Fair · Fever · Chills, Headache · Be unable to do your normal daily activitiesFree text: Cough,possible shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-12
Survey response — day 14, dose 2MedDRA: Discharge, Dyspnoea, Emergency care, Hospitalisation, Oedema, Pulmonary oedema — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: Hospitalized w/adema, shortness of breath, fluid tapped (lining R lung) · Healthcare visit (other): ParamedicsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-12
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-19
- 2021-06-23
- 2021-06-26
- 2021-07-03
- 2021-07-10
-
2021-08-18
Call successfulCompleted over the phone
- 2021-08-20
- 2021-08-28
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2021-11-22
Dose 3 — Moderna
- 2021-11-28
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2021-11-30
Survey response — day 7, dose 3MedDRA: Chills, Injection site pain, Pre-existing disease — Feeling: GoodFree text: I received the booster shot on 11/22/21 because I am immunocompromised, the next day I felt pain at the site and had chills for a few daysMedDRA releases: 2024-11 · check-in free text available
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2021-12-07
Survey response — day 14, dose 3MedDRA: Chills, Cough — Feeling: GoodFree text: Had cough/chillsMedDRA releases: 2024-11 · check-in free text available
- 2021-12-14
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2021-12-20
Survey response — day 28, dose 3MedDRA: Chills, Cough, Dizziness — Feeling: FairFree text: Dizziness, cough, chillsMedDRA releases: 2024-11 · check-in free text available
- 2021-12-27
- 2022-01-04
- 2022-02-22
- 2022-05-24
-
2022-07-02
Dose 4 — Moderna
- 2022-07-02
- 2022-07-04
- 2022-07-05
- 2022-07-06
- 2022-07-07
- 2022-07-08
- 2022-07-09
- 2022-07-16
- 2022-07-23
- 2022-07-30
- 2022-08-06
- 2022-08-13
- 2022-10-01
- 2022-12-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-01 | Moderna | |
| 2 | 2021-05-29 | Moderna | |
| 3 | 2021-11-22 | Moderna | No |
| 4 | 2022-07-02 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 8 — days 1–6 daily, dose 1
Systemic reaction (other): Sniffles, runny nose, mild sore throat
Systemic reaction (other): Cough
Systemic reaction (other): Night sweats (last night)
Release 8 — day 14, dose 1
Symptoms: Chills
Release 8 — day 0, dose 2
Systemic reaction (other): Back ache, sniffles, soar throat
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Slight cough and soar throat
Systemic reaction (other): Irritating cough
Systemic reaction (other): Cough, sniffles popover shortness of breath
Release 8 — day 7, dose 2
Systemic reaction (other): Cough,possible shortness of breath
Release 9 — day 14, dose 2
Symptoms: Hospitalized w/adema, shortness of breath, fluid tapped (lining R lung)
Healthcare visit (other): Paramedics
Release 10 — day 7, dose 3
Systemic reaction (other): I received the booster shot on 11/22/21 because I am immunocompromised, the next day I felt pain at the site and had chills for a few days
Release 10 — day 14, dose 3
Symptoms: Had cough/chills
Release 10 — day 28, dose 3
Symptoms: Dizziness, cough, chills
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 | Emergency care | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Discharge | ✓ | ✓ | ○ |
| SD | Dizziness | · | · | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Oedema | · | · | ✓ |
| SD | Pulmonary oedema | · | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release