MTW-80901-30120
3 vaccinations
7 coded responses
39 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 152 / PA
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
CWR-14718-12253
Child or adolescent in my care · Male · 2022-07-23
Timeline
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2021-01-15
Registered in v-safe
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2021-01-15
Dose 1 — Moderna
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-22
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2021-01-29
Survey response — day 14, dose 1MedDRA: Diarrhoea, Lip swelling, Paraesthesia oral, Swelling face — 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 consultation, Outpatient clinic or urgent care clinic visitFree text: Face swelling, lip swelling and tongue tingling on 1/24/21. Went to urgent care and received steroid shot and prescriptions for allergic reaction. Diarrhea 2x this week. More tingling after eating. Temporary VAERS e- report for more info (b)(6)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-29
Report sent to call center — day 14, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-07
Survey response — day 21, dose 1MedDRA: Dry throat, Hypersensitivity, Nausea, Paraesthesia oral, Specialist consultation — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Continued allergic reaction treatment, saw allergist on 2/5, recommended Zyrtec and allergy testing for continued mouth and tongue tingling after eating. Now might be having side effects from Zyrtec with dry throat and nausea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-07
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-12
Dose 2 — Moderna
- 2021-02-12
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2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-05-14
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2021-06-07
Call successfulReported to VAERS voluntarily prior to GDIT contact
- 2021-08-13
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2021-11-10
Dose 3 — Moderna
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2021-11-11
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-11-12
Survey response — days 1–6 daily, dose 3MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection siteFree text: Rash on left backside of knee since 11/5, from before shotMedDRA releases: 2024-11 · check-in free text available
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2021-11-13
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-11-14
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2021-11-15
Health check-in — days 1–6 daily, dose 3Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
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2021-11-16
Survey response — days 1–6 daily, dose 3MedDRA: Pre-existing disease — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Rash started before shot but still continuing, on left kneeMedDRA releases: 2024-11 · check-in free text available
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2021-11-17
Survey response — day 7, dose 3MedDRA: Pre-existing disease — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Rash was from before shot, still continuing in legMedDRA releases: 2024-11 · check-in free text available
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2021-12-22
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2022-02-09
Survey response — 3 months, dose 3MedDRA: Delivery — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: Healthy labor and delivery of baby at 39 weeks and one day, as expected and recovering normally, so on 6 weeks of short term disability as is typical. · Healthcare visit (other): As expected for a uncomplicated vaginal delivery of a full term babyMedDRA releases: 2024-11 · check-in free text available
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2022-02-09
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
- 2022-02-10
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2022-02-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-05-11
Survey response — 6 months, dose 3MedDRA: Myalgia — Feeling: GoodFree text: Muscle sorenessMedDRA releases: 2024-11 · check-in free text available
- 2022-11-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna | |
| 3 | 2021-11-10 | Moderna | No |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 1
Free text
Release 3 — day 14, dose 1
Symptoms: Face swelling, lip swelling and tongue tingling on 1/24/21. Went to urgent care and received steroid shot and prescriptions for allergic reaction. Diarrhea 2x this week. More tingling after eating. Temporary VAERS e- report for more info (b)(6)
redacted (b)(6)
Release 3 — day 21, dose 1
Symptoms: Continued allergic reaction treatment, saw allergist on 2/5, recommended Zyrtec and allergy testing for continued mouth and tongue tingling after eating. Now might be having side effects from Zyrtec with dry throat and nausea.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Rash on left backside of knee since 11/5, from before shot
Systemic reaction (other): Rash started before shot but still continuing, on left knee
Release 10 — day 7, dose 3
Systemic reaction (other): Rash was from before shot, still continuing in leg
Release 11 — 3 months, dose 3
Symptoms: Healthy labor and delivery of baby at 39 weeks and one day, as expected and recovering normally, so on 6 weeks of short term disability as is typical.
Healthcare visit (other): As expected for a uncomplicated vaginal delivery of a full term baby
Release 11 — 6 months, dose 3
Symptoms: Muscle soreness
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 | Delivery | · | · | ✓ |
| SD | Delivery | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dry throat | ✓ | ✓ | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Lip swelling | ✓ | ✓ | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Paraesthesia oral | ✓ | ✓ | ✓ |
| SD | Specialist consultation | ✓ | ✓ | ✓ |
| SD | Swelling face | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release