V5X-24879-84030
2 vaccinations
5 coded responses
12 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 495 / MI
- Registered
- 2021-01-15
- Relationship
- Self
Timeline
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2021-01-15
Registered in v-safe
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2021-01-15
Dose 1 — Moderna
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2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Feeling abnormal — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Foggy/dizzyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: DizzyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-20
Survey response — days 1–6 daily, dose 1MedDRA: Telemedicine — Feeling: Fair · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Telehealth 1/19MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-20
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-01-21
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-01-24
- 2021-01-29
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2021-02-05
Survey response — day 21, dose 1MedDRA: Cough, Ear infection, Upper-airway cough syndrome — Feeling: FairFree text: Cough, post nasal drip, ear infection,MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Dose 2 — Moderna
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2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-02-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness · HeadacheAdult check-in
- 2021-02-18
- 2021-02-19
- 2021-03-05
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2021-03-08
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-20 | Successful 2021-03-08 |
Participant prefers to complete VAERS report online |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Foggy/dizzy
Systemic reaction (other): Dizzy
Systemic reaction (other): Dizziness
Healthcare visit (other): Telehealth 1/19
Release 3 — day 21, dose 1
Symptoms: Cough, post nasal drip, ear infection,
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 | Telemedicine | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Ear infection | ✓ | ✓ | ✓ |
| SD | Upper-airway cough syndrome | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release