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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

  1. 2021-03-10
    Registered in v-safe
  2. 2021-03-10
    Dose 1 — Moderna
  3. 2021-03-10
    Survey response — day 0, dose 1
    MedDRA: Chest pain, Dysgeusia, Heart rate increased, Throat irritation — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Rapid heart rate, Can taste the vaccine, burning in throat and chest
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: 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 activities
    Adult check-in
  5. 2021-03-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  6. 2021-03-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  7. 2021-03-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  8. 2021-03-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-03-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  10. 2021-03-24
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-31
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-04-07
    Dose 2 — Moderna
  13. 2021-04-07
    Survey response — day 0, dose 2
    MedDRA: Chest pain, Dysgeusia, Immediate post-injection reaction, Parosmia — Feeling: Fair · Headache, Muscle or body aches
    Free 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
  14. 2021-04-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: 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 activities
    Adult check-in
  15. 2021-04-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Abdominal pain
    Adult check-in
  16. 2021-04-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  17. 2021-04-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  18. 2021-04-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea
    Adult check-in
  19. 2021-04-14
    Health check-in — day 7, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  20. 2021-07-07
    Survey response — 3 months, dose 2
    MedDRA: Abortion spontaneous, Fatigue — Feeling: Good
    Free text: Extreme exhaustion since vaccination. Miscarriage.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-10-06
    Survey response — 6 months, dose 2
    MedDRA: Coagulopathy, Ectopic pregnancy, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free 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 vaccination
    MedDRA releases: 2024-11 · check-in free text available
  22. 2021-10-06
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  23. 2021-10-07
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-03-10Moderna
22021-04-07Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-10-06 Successful
2021-10-07
Participant prefers to complete VAERS report online

Free text

Release 5 — day 0, dose 1

2021-03-10

Systemic reaction (other): Rapid heart rate, Can taste the vaccine, burning in throat and chest

Release 7 — day 0, dose 2

2021-04-07

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

2021-07-07

Symptoms: Extreme exhaustion since vaccination. Miscarriage.

Release 10 — 6 months, dose 2

2021-10-06

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

FieldPreferred term2021-092023-042024-11
SDAbortion spontaneous ✓ ✓ ✓
SDCoagulopathy · · ✓
SDEctopic pregnancy · · ✓
SDFatigue ✓ ✓ ✓
SDPre-existing disease · · ✓
SROChest pain ✓ ✓ ✓
SRODysgeusia ✓ ✓ ✓
SROHeart rate increased ✓ ✓ ✓
SROImmediate post-injection reaction ✓ ✓ ✓
SROParosmia ✓ ✓ ✓
SROThroat irritation ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release