Y78-87591-95301
2 vaccinations
5 coded responses
17 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 757 / TX
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-04-08
Registered in v-safe
-
2021-04-08
Dose 1 — Moderna
-
2021-04-08
Health check-in — day 0, dose 1Feeling: Fair · Headache, Joint pains, Fatigue or tirednessAdult check-in
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
-
2021-04-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Fatigue or tirednessAdult check-in
-
2021-04-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-15
- 2021-04-22
- 2021-04-29
-
2021-05-05
Dose 2 — Moderna
- 2021-05-20
- 2021-05-26
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2021-06-02
Survey response — day 28, dose 2MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: HeadachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-09
Survey response — day 35, dose 2MedDRA: Abdominal discomfort, Dizziness, Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Headache, dizzyness, mild upset stomach.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-16
Survey response — day 42, dose 2MedDRA: Chest pain, Emergency care, Hypertension, Vertigo — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Vertigo, chest pains, extreamly high blood pressure. ER visit for these sympotms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-16
Report sent to call center — day 42, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
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2021-06-23
Call successfulDoes not wish to fill out VAERS report
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2021-08-04
Survey response — 3 months, dose 2MedDRA: COVID-19, Rash — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Got Covid and now have Covid Rash.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-04
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-08-14
Call successfulParticipant prefers to complete VAERS report online
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2021-11-03
Survey response — 6 months, dose 2MedDRA: Condition aggravated, Dyspnoea, Macular degeneration, Pre-existing disease — Feeling: FairFree text: Breathing is at times harder, macular degeneratipn starting now, heart issues have increased from one moderate leaking valve to 2 moderate valves leaking and 2 slightly leaking. Surgery at this time is not a option will have esophageal echo done soonMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-08 | Moderna | |
| 2 | 2021-05-05 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-16 | Successful 2021-06-23 |
Does not wish to fill out VAERS report |
| 2021-08-04 | Successful 2021-08-14 |
Participant prefers to complete VAERS report online |
Free text
Release 8 — day 28, dose 2
Symptoms: Headaches
Release 9 — day 35, dose 2
Symptoms: Headache, dizzyness, mild upset stomach.
Release 9 — day 42, dose 2
Symptoms: Vertigo, chest pains, extreamly high blood pressure. ER visit for these sympotms.
Release 9 — 3 months, dose 2
Symptoms: Got Covid and now have Covid Rash.
Release 10 — 6 months, dose 2
Symptoms: Breathing is at times harder, macular degeneratipn starting now, heart issues have increased from one moderate leaking valve to 2 moderate valves leaking and 2 slightly leaking. Surgery at this time is not a option will have esophageal echo done soon cut off by CDC
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 | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | COVID-19 | ✓ | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hypertension | ✓ | ✓ | ✓ |
| SD | Macular degeneration | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rash | ✓ | · | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release