XA7-89637-71565
2 vaccinations
4 coded responses
18 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 191 / PA
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-10
Registered in v-safe
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2021-03-10
Dose 1 — Moderna
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2021-03-10
Survey response — day 0, dose 1MedDRA: Chest pain, Dysgeusia, Heart rate increased, Throat irritation — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Rapid heart rate, Can taste the vaccine, burning in throat and chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-03-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-13
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-14
Health check-in — days 1–6 daily, dose 1Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-15
- 2021-03-16
- 2021-03-24
- 2021-03-31
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2021-04-07
Dose 2 — Moderna
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2021-04-07
Survey response — day 0, dose 2MedDRA: Chest pain, Dysgeusia, Immediate post-injection reaction, Parosmia — Feeling: Fair · Headache, Muscle or body achesFree text: Strange immediate taste and smell when injected. Pain on the opposite side of where I received the vaccination on my chest like I was hit there.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-04-10
- 2021-04-11
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2021-04-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-04-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
- 2021-04-14
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2021-07-07
Survey response — 3 months, dose 2MedDRA: Abortion spontaneous, Fatigue — Feeling: GoodFree text: Extreme exhaustion since vaccination. Miscarriage.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-10-06
Survey response — 6 months, dose 2MedDRA: Coagulopathy, Ectopic pregnancy, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Clotting issues/ectopic pregnancy after vaccination. Had the same clotting issues for months after I had Covid in Feb of 2020 and they resurfaced worse after vaccinationMedDRA releases: 2024-11 · check-in free text available
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2021-10-06
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
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2021-10-07
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Moderna | |
| 2 | 2021-04-07 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-06 | Successful 2021-10-07 |
Participant prefers to complete VAERS report online |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Rapid heart rate, Can taste the vaccine, burning in throat and chest
Release 7 — day 0, dose 2
Systemic reaction (other): Strange immediate taste and smell when injected. Pain on the opposite side of where I received the vaccination on my chest like I was hit there.
Release 9 — 3 months, dose 2
Symptoms: Extreme exhaustion since vaccination. Miscarriage.
Release 10 — 6 months, dose 2
Symptoms: Clotting issues/ectopic pregnancy after vaccination. Had the same clotting issues for months after I had Covid in Feb of 2020 and they resurfaced worse after vaccination
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 | Abortion spontaneous | ✓ | ✓ | ✓ |
| SD | Coagulopathy | · | · | ✓ |
| SD | Ectopic pregnancy | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Parosmia | ✓ | ✓ | ✓ |
| SRO | Throat irritation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release