6R2-14429-17612
5 vaccinations
5 coded responses
63 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 660 / KS
- Registered
- 2021-02-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-16
Registered in v-safe
-
2021-02-16
Dose 1 — Moderna
- 2021-02-16
- 2021-02-17
-
2021-02-18
Survey response — days 1–6 daily, dose 1MedDRA: Nausea — Feeling: Good · FeverFree text: Ive had intermittent queasiness, not to the degree Id classify as nausea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
-
2021-03-18
Dose 2 — Moderna
- 2021-03-18
-
2021-03-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
-
2021-03-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-21
-
2021-03-23
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: GoodFree text: Injection was administered into left deltoid. Yesterday afternoon, I noticed slight, solitary swelling in a left lymph node which is not tender on palpation. Am monitoring. Last mammo was October 2020, Birads II, unremarkable except on noting dense breast tissue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-06-17
- 2021-09-18
-
2021-11-08
Dose 3 — Moderna
- 2021-11-08
-
2021-11-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
- 2021-11-11
- 2021-11-12
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-13
- 2021-12-20
- 2022-02-07
-
2022-05-03
Dose 4 — Moderna
-
2022-05-04
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessAdult check-in
- 2022-05-05
- 2022-05-06
- 2022-05-08
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-06-14
- 2022-08-02
-
2022-10-29
Dose 5 — Moderna
- 2022-10-29
-
2022-10-30
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-10-31
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
-
2022-11-01
Survey response — days 1–6 daily, dose 5MedDRA: Blood pressure decreased, Heart rate increased, Hypotension, Oxygen saturation decreased — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: BP 88/59 mmHg, Pulse 110. I'm not normally hypotensive. Pulse ox ranging 80-92. This is also lower for me than usual.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-02
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Fatigue or tiredness, DiarrheaAdult check-in
- 2022-11-03
- 2022-11-05
-
2022-11-12
Survey response — day 14, dose 5MedDRA: Blood pressure abnormal, Dizziness, Hyperhidrosis, Hypotension, Oxygen saturation abnormal, Presyncope, Pulse abnormal — Feeling: Good · Be unable to do your normal daily activitiesFree text: I had an episode yesterday of pre-syncope, accompanied by hypotension, diaphoresis, and dizziness. BP was 86/54 mmHg. Pulse 78/min. O2 sat 92. Absent hypovolemia. Am following with my PCP on Monday, November 21st. Not necessarily vaccine related.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-19
- 2022-11-26
- 2022-12-03
- 2022-12-10
- 2023-01-30
-
2023-04-29
Survey response — 6 months, dose 5MedDRA: Blood pressure increased, COVID-19 — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-04-29
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-05-02
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-16 | Moderna | |
| 2 | 2021-03-18 | Moderna | |
| 3 | 2021-11-08 | Moderna | No |
| 4 | 2022-05-03 | Moderna | No |
| 5 | 2022-10-29 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Ive had intermittent queasiness, not to the degree Id classify as nausea.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Injection was administered into left deltoid. Yesterday afternoon, I noticed slight, solitary swelling in a left lymph node which is not tender on palpation. Am monitoring. Last mammo was October 2020, Birads II, unremarkable except on noting dense breast tissue.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): BP 88/59 mmHg, Pulse 110. I'm not normally hypotensive. Pulse ox ranging 80-92. This is also lower for me than usual.
Release 12 — day 14, dose 5
Symptoms: I had an episode yesterday of pre-syncope, accompanied by hypotension, diaphoresis, and dizziness. BP was 86/54 mmHg. Pulse 78/min. O2 sat 92. Absent hypovolemia. Am following with my PCP on Monday, November 21st. Not necessarily vaccine related.
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 pressure abnormal | · | · | ✓ |
| SD | Blood pressure increased | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Hyperhidrosis | · | · | ✓ |
| SD | Hypotension | · | · | ✓ |
| SD | Oxygen saturation abnormal | · | · | ✓ |
| SD | Presyncope | · | · | ✓ |
| SD | Pulse abnormal | · | · | ✓ |
| SRO | Blood pressure decreased | · | · | ✓ |
| SRO | Heart rate increased | · | · | ✓ |
| SRO | Hypotension | · | · | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Oxygen saturation decreased | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release