6SH-27603-80159
4 vaccinations
9 coded responses
53 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 983 / WA
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Moderna
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2021-02-03
Survey response — day 0, dose 1MedDRA: Dizziness, Dysgeusia, Palpitations — Feeling: Good · HeadacheFree text: Dizziness, heart racing, odd taste in mouth all shortly after the shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
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2021-03-03
Survey response — day 0, dose 2MedDRA: Dizziness, Palpitations, Reaction to previous exposure to any vaccine — Feeling: Fair · Headache, Fatigue or tirednessFree text: At time of the shot, some heart racing and feeling faint/dizziness. Same reactipn as first one.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness, Hypoaesthesia — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Feel dizzy. Sort of numb brained.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-03-06
- 2021-03-07
- 2021-03-09
- 2021-03-10
-
2021-03-17
Survey response — day 14, dose 2MedDRA: Gastrointestinal disorder — Feeling: FairFree text: Intestinal problems started. They seem to be getting a bit better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-06-02
- 2021-09-01
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2021-10-28
Dose 3 — Moderna
- 2021-10-28
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2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2022-01-27
- 2022-04-28
-
2022-06-20
Dose 4 — Moderna
- 2022-06-20
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2022-06-21
Survey response — days 1–6 daily, dose 4MedDRA: Eyelids pruritus, Immediate post-injection reaction, Swelling of eyelid — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Swollen, itchy eyelids. Started within an hour of the vaccine being give · Healthcare visit (other): Called about swelling of eyelids. Have not heard back.MedDRA releases: 2024-11 · check-in free text available
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2022-06-21
Report sent to call center — days 1–6 daily, dose 4Get care from a doctor or other healthcare professional1 call case(s)
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2022-06-22
Survey response — days 1–6 daily, dose 4MedDRA: Erythema of eyelid, Eyelids pruritus, Swelling of eyelid — Feeling: FairFree text: I still am experiencing swollen, red, itchy, eyelids. Slight improvement is all.MedDRA releases: 2024-11 · check-in free text available
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2022-06-22
Call successfulCompleted over the phone
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2022-06-23
Survey response — days 1–6 daily, dose 4MedDRA: Erythema of eyelid, Eyelids pruritus, Swelling of eyelid — Feeling: Fair · Fatigue or tirednessFree text: Still some swelling,redness, and itchiness on eyelids, hiwever much better today.MedDRA releases: 2024-11 · check-in free text available
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2022-06-24
Survey response — days 1–6 daily, dose 4MedDRA: Erythema of eyelid — Feeling: FairFree text: Still a little redness on the eyelids but it is resolving.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-26
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2022-06-29
Survey response — day 7, dose 4MedDRA: Ocular hyperaemia — Feeling: GoodFree text: Still some redness of my eyes. My daughter commented on it again today.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-06
- 2022-07-13
- 2022-07-18
- 2022-07-27
- 2022-08-01
- 2022-09-21
- 2023-06-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-06-20 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 3 — day 0, dose 1
Systemic reaction (other): Dizziness, heart racing, odd taste in mouth all shortly after the shot
Release 5 — day 0, dose 2
Systemic reaction (other): At time of the shot, some heart racing and feeling faint/dizziness. Same reactipn as first one.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Feel dizzy. Sort of numb brained.
Release 5 — day 14, dose 2
Symptoms: Intestinal problems started. They seem to be getting a bit better today.
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Swollen, itchy eyelids. Started within an hour of the vaccine being give
Healthcare visit (other): Called about swelling of eyelids. Have not heard back.
Systemic reaction (other): I still am experiencing swollen, red, itchy, eyelids. Slight improvement is all.
Systemic reaction (other): Still some swelling,redness, and itchiness on eyelids, hiwever much better today.
Systemic reaction (other): Still a little redness on the eyelids but it is resolving.
Release 12 — day 7, dose 4
Systemic reaction (other): Still some redness of my eyes. My daughter commented on it again today.
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 | Swelling of eyelid | · | · | ✓ |
| SD | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Erythema of eyelid | · | · | ✓ |
| SRO | Eyelids pruritus | · | · | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | · | · | ✓ |
| SRO | Ocular hyperaemia | · | · | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | ✓ | ✓ | ✓ |
| SRO | Swelling of eyelid | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release