6U3-67130-83618
4 vaccinations
4 coded responses
47 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 752 / TX
- 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
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
-
2021-01-13
Health check-in — day 7, dose 1Feeling: Fair · Site: Itching · None · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
-
2021-01-13
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-18
- 2021-01-25
-
2021-02-01
Dose 2 — Moderna
- 2021-02-01
-
2021-02-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-03
- 2021-02-04
- 2021-02-05
-
2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-02-07
-
2021-02-08
Survey response — day 7, dose 2MedDRA: Medical counselling — Feeling: Poor · Abdominal pain · Get care from a doctor or other healthcare professionalFree text: PrescriptionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-08
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-03
-
2021-03-03
Call successfulDoes not wish to fill out VAERS report
- 2021-03-08
- 2021-03-15
- 2021-05-03
- 2021-08-02
-
2021-10-24
Dose 3 — Moderna
-
2021-10-24
Health check-in — day 0, dose 3Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fatigue or tiredness, Abdominal painAdult check-in
- 2021-11-02
- 2021-11-07
- 2021-11-14
- 2021-11-21
-
2021-11-28
Survey response — day 35, dose 3MedDRA: Fatigue, Initial insomnia, Insomnia, Middle insomnia, Palpitations, Somnolence — Feeling: PoorFree text: Heart publications, feeling tired. Trouble sleeping, waking during the night and not being able to go back to sleep. Then having to take a nap during the day.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-05
Survey response — day 42, dose 3MedDRA: Emergency care, Heart rate increased, Ventricular extrasystoles — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Rapid heart rate. And PVC that the emergency room at Presbyterian emergency room told me I had.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-05
Report sent to call center — day 42, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2021-12-06
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-01-23
Survey response — 3 months, dose 3MedDRA: Aortic aneurysm — Feeling: Poor · Be unable to do your normal daily activitiesFree text: I have developed an aneurysm in my pancreas, it is wrapped around the aorta that feeds the pancreas. It wasn't there three years ago when I had a CAT scan.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-20
Dose 4 — Moderna
-
2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Abdominal painAdult check-in
-
2022-04-24
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Abdominal painAdult check-in
- 2022-04-26
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-06-01
- 2022-07-22
- 2022-10-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-01 | Moderna | |
| 3 | 2021-10-24 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 3 — day 7, dose 2
Healthcare visit (other): Prescription
Release 10 — day 35, dose 3
Symptoms: Heart publications, feeling tired. Trouble sleeping, waking during the night and not being able to go back to sleep. Then having to take a nap during the day.
Release 10 — day 42, dose 3
Symptoms: Rapid heart rate. And PVC that the emergency room at Presbyterian emergency room told me I had.
Release 11 — 3 months, dose 3
Symptoms: I have developed an aneurysm in my pancreas, it is wrapped around the aorta that feeds the pancreas. It wasn't there three years ago when I had a CAT scan.
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 | Medical counselling | ✓ | ✓ | ✓ |
| SD | Aortic aneurysm | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Heart rate increased | · | · | ✓ |
| SD | Initial insomnia | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Middle insomnia | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SD | Ventricular extrasystoles | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release