6M7-16877-74008
4 vaccinations
17 coded responses
39 check-ins
16 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 986 / WA
- Registered
- 2021-04-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-21
Dose 1 — Moderna
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2021-04-28
Registered in v-safe
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2021-04-28
Survey response — day 7, dose 1MedDRA: Axillary pain — Feeling: FairFree text: Painful armpitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-05
Survey response — day 14, dose 1MedDRA: Emergency care, Palpitations, Tachycardia — Feeling: Good · Be unable to workFree text: I had heart palpitations and tachycardia with the highest heart beats per minute of 202. I went to the ER for this and test results were negative for heart attack and blockages. This occurred on Thursday, April 29 at 10:30 AM.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
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2021-05-19
Dose 2 — Moderna
- 2021-05-19
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2021-05-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to workAdult check-in
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2021-05-21
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
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2021-05-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
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2021-05-23
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal distension, Abdominal pain — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Abdominal painFree text: Yesterday After I made my report, I experienced abdominal pain and bloating that lasted eight hours and resolved upon waking this morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-24
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
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2021-05-25
Survey response — days 1–6 daily, dose 2MedDRA: Tachycardia — Feeling: Good · Site: Redness, ItchingFree text: Tachycardia with heart rate above 120 three times today. Highest heart rate was 133 on a flat walk.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-27
- 2021-06-05
- 2021-06-11
- 2021-06-25
- 2021-07-01
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2021-08-25
Survey response — 3 months, dose 2MedDRA: Supraventricular tachycardia — Feeling: FairFree text: Supra-ventricular tachycardiaMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-11-19
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2021-11-20
Dose 3 — Moderna
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2021-11-20
Survey response — day 0, dose 3MedDRA: Brain fog — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Lack of mental clarityMedDRA releases: 2024-11 · check-in free text available
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2021-11-21
Survey response — days 1–6 daily, dose 3MedDRA: Cardiac flutter — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Heart fluttersMedDRA releases: 2024-11 · check-in free text available
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2021-11-22
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Good · Site: PainFree text: Lymph node swelling under armMedDRA releases: 2024-11 · check-in free text available
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2021-11-23
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Good · Site: PainFree text: Lymph node swellingMedDRA releases: 2024-11 · check-in free text available
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2021-11-25
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fatigue or tiredness, NauseaAdult check-in
- 2021-11-26
- 2021-11-27
- 2021-12-06
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2021-12-11
Survey response — day 21, dose 3MedDRA: Blood glucose decreased — Feeling: GoodFree text: More severe incidents of low blood sugar. I am Not diabetic.MedDRA releases: 2024-11 · check-in free text available
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2021-12-18
Survey response — day 28, dose 3MedDRA: Nasal congestion, Rhinorrhoea — Feeling: FairFree text: Nasal congestion Runny noseMedDRA releases: 2024-11 · check-in free text available
- 2021-12-25
- 2022-01-01
- 2022-02-21
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2022-04-08
Dose 4 — Moderna
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2022-04-16
Survey response — day 7, dose 4MedDRA: Arthralgia, Chills, Fatigue — Feeling: GoodFree text: No but I had chills & joint pains & tiredness for 2 days after the shot.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-22
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2022-05-03
Survey response — day 21, dose 4MedDRA: Hypoglycaemia — Feeling: GoodFree text: HypoglycemiaMedDRA releases: 2024-11 · check-in free text available
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2022-05-06
Survey response — day 28, dose 4MedDRA: Hypoglycaemia — Feeling: GoodFree text: HypoglycemiaMedDRA releases: 2024-11 · check-in free text available
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2022-05-14
Survey response — day 35, dose 4MedDRA: Fatigue — Feeling: GoodFree text: Tired all the timeMedDRA releases: 2024-11 · check-in free text available
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2022-05-20
Survey response — day 42, dose 4MedDRA: Supraventricular tachycardia — Feeling: GoodFree text: Supra ventricular tachycardia- heart rate between 175 & 192 bpmMedDRA releases: 2024-11 · check-in free text available
- 2022-07-10
- 2022-10-09
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2023-04-08
Survey response — 12 months, dose 4MedDRA: COVID-19, Cough, Nasopharyngitis — 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 consultationMedDRA releases: 2024-11
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2023-04-08
Report sent to call center — 12 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-04-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-21 | Moderna | |
| 2 | 2021-05-19 | Moderna | |
| 3 | 2021-11-20 | Moderna | No |
| 4 | 2022-04-08 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 8 — day 7, dose 1
Systemic reaction (other): Painful armpit
Release 8 — day 14, dose 1
Symptoms: I had heart palpitations and tachycardia with the highest heart beats per minute of 202. I went to the ER for this and test results were negative for heart attack and blockages. This occurred on Thursday, April 29 at 10:30 AM.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Yesterday After I made my report, I experienced abdominal pain and bloating that lasted eight hours and resolved upon waking this morning
Systemic reaction (other): Tachycardia with heart rate above 120 three times today. Highest heart rate was 133 on a flat walk.
Release 9 — 3 months, dose 2
Symptoms: Supra-ventricular tachycardia
Release 10 — day 0, dose 3
Systemic reaction (other): Lack of mental clarity
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Heart flutters
Systemic reaction (other): Lymph node swelling under arm
Systemic reaction (other): Lymph node swelling
Release 10 — day 21, dose 3
Symptoms: More severe incidents of low blood sugar. I am Not diabetic.
Release 10 — day 28, dose 3
Symptoms: Nasal congestion Runny nose
Release 11 — day 7, dose 4
Systemic reaction (other): No but I had chills & joint pains & tiredness for 2 days after the shot.
Release 11 — day 21, dose 4
Symptoms: Hypoglycemia
Release 11 — day 28, dose 4
Symptoms: Hypoglycemia
Release 11 — day 35, dose 4
Symptoms: Tired all the time
Release 11 — day 42, dose 4
Symptoms: Supra ventricular tachycardia- heart rate between 175 & 192 bpm
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 | Blood glucose decreased | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Hypoglycaemia | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Supraventricular tachycardia | ✓ | · | ✓ |
| SD | Tachycardia | ✓ | ✓ | ✓ |
| SRO | Abdominal distension | ✓ | ✓ | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Cardiac flutter | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Tachycardia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release