Y4Q-15980-91392
5 vaccinations
8 coded responses
59 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 857 / AZ
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Registered dependents
2GC-31386-12397
Adult relative or friend · Female · 2021-10-27
Timeline
-
2021-01-11
Registered in v-safe
-
2021-01-11
Dose 1 — Moderna
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2021-01-11
Survey response — day 0, dose 1MedDRA: Cardiac flutter, Hypoaesthesia — Feeling: Fair · Site: Pain · Be unable to do your normal daily activitiesFree text: For about 1.5 hours, my head felt a bit "numb". My chest felt "occasional fluttersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-11
Report sent to call center — day 0, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-25
- 2021-02-01
-
2021-02-08
Dose 2 — Moderna
- 2021-02-08
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-10
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-05-10
- 2021-08-09
-
2021-10-26
Dose 3 — Moderna
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2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Feeling hot — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Feeling hotMedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Cardiac flutter, Chest discomfort, Dyspnoea, Heart rate increased — Feeling: Fair · Site: Pain, Swelling · Joint pains · Be unable to work or attend schoolFree text: Yesterday for 3-4 hrs, upon exertion, I had heaviness in chest, shortness of breath and felt fluttering/increase heart rate. Normal resting pulse is 63 - pulse up to 87 when experiencing symptoms. Relieved by rest.MedDRA releases: 2024-11 · check-in free text available
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2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Cardiac flutter, Chest discomfort, Dyspnoea — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend schoolFree text: Heaviness and fluttering in chest. Mild shortness of breath.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Bundle branch block left, Cardiac flutter, Chest discomfort, Dyspnoea, Emergency care, Palpitations — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend schoolFree text: Chest fluttering, heaviness, and short of breath. Went to ER had EKGs, chest x-ray and labs. Diagnosed with palpitations and left bundle branch block in EKG. . To f/u w/cardiologist.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
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2021-11-02
Survey response — day 7, dose 3MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2022-01-25
-
2022-04-11
Dose 4 — Pfizer-BioNTech
- 2022-04-15
- 2022-04-16
- 2022-04-20
- 2022-04-25
- 2022-05-02
- 2022-05-09
- 2022-05-16
- 2022-05-23
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2022-07-13
Survey response — 3 months, dose 4MedDRA: COVID-19, Cough, Dizziness, Ear pain, Hypoacusis, Nasal congestion, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, Visual impairment — Feeling: Fair · Be unable to work or attend schoolFree text: Covid 19. Sore throat, fever, body aches, nasal stuffiness and drainage, ear pain, vision changes, dizziness, decreased hearing, cough. 4d after testing negative, experienced rebound w/same symptoms but worse intensity.MedDRA releases: 2024-11 · check-in free text available
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2022-10-04
Dose 5 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-05
-
2022-10-07
Health check-in — days 1–6 daily, dose 5Feeling: Good · Headache, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
- 2022-10-08
- 2022-10-09
-
2022-10-10
Survey response — days 1–6 daily, dose 5MedDRA: Abdominal pain, Vomiting — Feeling: Good · Abdominal painFree text: Abdominal pain and vomited last night.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-11
- 2022-10-18
- 2022-10-27
- 2022-11-01
- 2022-11-08
- 2022-11-15
- 2023-01-03
- 2023-04-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-04-11 | Pfizer-BioNTech | No |
| 5 | 2022-10-04 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-11 | priority 2/3 |
Free text
Release 1 — day 0, dose 1
Systemic reaction (other): For about 1.5 hours, my head felt a bit "numb". My chest felt "occasional flutters
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Feeling hot
Systemic reaction (other): Yesterday for 3-4 hrs, upon exertion, I had heaviness in chest, shortness of breath and felt fluttering/increase heart rate. Normal resting pulse is 63 - pulse up to 87 when experiencing symptoms. Relieved by rest.
Systemic reaction (other): Heaviness and fluttering in chest. Mild shortness of breath.
Systemic reaction (other): Chest fluttering, heaviness, and short of breath. Went to ER had EKGs, chest x-ray and labs. Diagnosed with palpitations and left bundle branch block in EKG. . To f/u w/cardiologist.
Release 10 — day 7, dose 3
Systemic reaction (other): Sore throat
Release 12 — 3 months, dose 4
Symptoms: Covid 19. Sore throat, fever, body aches, nasal stuffiness and drainage, ear pain, vision changes, dizziness, decreased hearing, cough. 4d after testing negative, experienced rebound w/same symptoms but worse intensity.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Abdominal pain and vomited last night.
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 | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Ear pain | · | · | ✓ |
| SD | Hypoacusis | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Visual impairment | · | · | ✓ |
| SRO | Abdominal pain | · | · | ✓ |
| SRO | Bundle branch block left | · | · | ✓ |
| SRO | Cardiac flutter | ✓ | ✓ | ✓ |
| SRO | Chest discomfort | · | · | ✓ |
| SRO | Dyspnoea | · | · | ✓ |
| SRO | Emergency care | · | · | ✓ |
| SRO | Feeling hot | · | · | ✓ |
| SRO | Heart rate increased | · | · | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Palpitations | · | · | ✓ |
| SRO | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release