6Q3-33925-66398
5 vaccinations
8 coded responses
29 check-ins
8 free-text entries
6 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 981 / WA
- Registered
- 2021-01-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-04
Registered in v-safe
-
2021-01-04
Dose 1 — Moderna
- 2021-01-04
-
2021-01-05
Survey response — days 1–6 daily, dose 1MedDRA: Myalgia — Feeling: Good · Site: PainFree text: Slight muscle ache all over but only while taking a hot shower. It went away after 10 minutesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-06
- 2021-01-07
- 2021-01-08
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2021-01-09
Survey response — days 1–6 daily, dose 1MedDRA: Injection site erythema — Feeling: Good · Site: RednessFree text: When I took off my bandage finally today there was a 1 mm very dark red dot where I got the injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-10
- 2021-01-11
- 2021-01-18
- 2021-01-25
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2021-02-01
Dose 2 — Moderna
- 2021-02-01
-
2021-02-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · 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 2Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-05
- 2021-02-06
- 2021-02-15
- 2021-02-22
- 2021-03-01
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2021-03-08
Survey response — day 35, dose 2MedDRA: Dental fluoride therapy, Gastrointestinal disorder, Gastrointestinal tract irritation, Procedural complication — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: SEVERE ADVERSE GI REACTION TO A FLUORIDE TREATMENT. NEVER HAD ANYTHING LIKE IT IN MY LIFEMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Report sent to call center — day 35, 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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2021-03-15
Survey response — day 42, dose 2MedDRA: Abdominal distension, Eye pain, Eye swelling, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Sore swollen painful eyes and GI bloat issues · Healthcare visit (other): Made appt for tomorrow at drs officeto see dr in office tomorrowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-05-03
Survey response — 3 months, dose 2MedDRA: Hypersensitivity — 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: Severe allergic reaction eye and skin on face from wearing a Demetech n95 mask. I wondered if you have had anyone mention problems with demetech masksMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-03
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-08-05
Survey response — 6 months, dose 2MedDRA: Chest pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Chest painMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-05
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-16
- 2021-08-19
-
2021-08-25
Dose 3 — Moderna
- 2021-11-29
-
2022-02-07
Dose 4 — Moderna
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2022-02-24
Survey response — 6 months, dose 3MedDRA: Office visit, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Ringing in ears especially right one all the time · Healthcare visit (other): Visited my private physician and changed somomeds but did not helpMedDRA releases: 2024-11 · check-in free text available
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2022-02-24
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2022-02-25
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2022-05-09
Survey response — 3 months, dose 4MedDRA: Seizure, Tinnitus — Feeling: Poor · 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: Conscious seizures and tibtinnusMedDRA releases: 2024-11 · check-in free text available
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2022-05-09
Report sent to call center — 3 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-10
- 2022-05-11
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2022-05-12
Callback requested for03:00PM ET
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2022-05-12
Call successfulCompleted over the phone
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2022-09-08
Dose 5 — Pfizer-BioNTech
- 2022-09-19
- 2022-09-22
- 2022-10-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-01 | Moderna | |
| 3 | 2021-08-25 | Moderna | No |
| 4 | 2022-02-07 | Moderna | No |
| 5 | 2022-09-08 | Pfizer-BioNTech | No |
Call center
6 call center cases
6 successful
VAERS report filed, before or during a call: 1
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Slight muscle ache all over but only while taking a hot shower. It went away after 10 minutes
Systemic reaction (other): When I took off my bandage finally today there was a 1 mm very dark red dot where I got the injection
Release 5 — day 35, dose 2
Symptoms: SEVERE ADVERSE GI REACTION TO A FLUORIDE TREATMENT. NEVER HAD ANYTHING LIKE IT IN MY LIFE
Release 5 — day 42, dose 2
Symptoms: Sore swollen painful eyes and GI bloat issues
Healthcare visit (other): Made appt for tomorrow at drs officeto see dr in office tomorrow
Release 8 — 3 months, dose 2
Symptoms: Severe allergic reaction eye and skin on face from wearing a Demetech n95 mask. I wondered if you have had anyone mention problems with demetech masks
Release 9 — 6 months, dose 2
Symptoms: Chest pain
Release 11 — 6 months, dose 3
Symptoms: Ringing in ears especially right one all the time
Healthcare visit (other): Visited my private physician and changed somomeds but did not help
Release 11 — 3 months, dose 4
Symptoms: Conscious seizures and tibtinnus
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 | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | · | ✓ |
| SD | Dental fluoride therapy | ✓ | · | ✓ |
| SD | Eye pain | ✓ | ✓ | ✓ |
| SD | Eye swelling | ✓ | ✓ | ✓ |
| SD | Gastrointestinal disorder | ✓ | · | ✓ |
| SD | Gastrointestinal tract irritation | ○ | ✓ | ○ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Procedural complication | ✓ | · | ✓ |
| SD | Seizure | · | · | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release