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Z44-36049-62725

2 vaccinations 4 coded responses 19 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
741 / OK
Registered
2021-01-30
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-21
    Dose 1 — Moderna
  2. 2021-01-30
    Registered in v-safe
  3. 2021-01-30
    Health check-in — day 7, dose 1
    Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness
    Adult check-in
  4. 2021-02-04
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-02-12
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-02-18
    Dose 2 — Moderna
  7. 2021-02-18
    Health check-in — day 0, dose 2
    Feeling: Fair · Headache
    Adult check-in
  8. 2021-02-19
    Survey response — days 1–6 daily, dose 2
    MedDRA: Heart rate increased, Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness
    Free text: Resting heart rate is elevated, and was after first dose also. I dont have swollen gland in armpit but did a week after first dose. No chills this time (mild last time).
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  10. 2021-02-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-02-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-02-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Chills, Headache, Fatigue or tiredness
    Adult check-in
  14. 2021-02-25
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-03-04
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-03-11
    Survey response — day 21, dose 2
    MedDRA: Chills, Headache — Feeling: Good
    Free text: Last Friday & Saturday I had a headache, mild chills & couldnt get warm onFriday night. Since this is similar to what I experienced after vaccination Ive chalked it up to that. Feeling fine now.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-18
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-25
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-04-01
    Survey response — day 42, dose 2
    MedDRA: Lymphadenopathy — Feeling: Good
    Free text: Had a swollen gland in right side of neck ( opposite side of shot), but it is allergy season & just started using CPAP nasal pillow. Lasted a few days & now gone.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-05-20
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-08-19
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2022-02-18
    Survey response — 12 months, dose 2
    MedDRA: Pulmonary thrombosis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization
    Free text: At the end of October 2021, I had 4 blood clots removed from my lungs (2 in each). I did not have Covid or the flu at that time. My booster was postponed until December as a result, but I have had it.
    MedDRA releases: 2024-11 · check-in free text available
  23. 2022-02-18
    Report sent to call center — 12 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · Hospitalization · 1 call case(s)
  24. 2022-02-22
  25. 2022-03-01
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-01-21Moderna
22021-02-18Moderna

Call center

ReportedOutcomeVAERS-related outcome
2022-02-18 Successful
2022-03-01
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-19

Systemic reaction (other): Resting heart rate is elevated, and was after first dose also. I dont have swollen gland in armpit but did a week after first dose. No chills this time (mild last time).

Release 5 — day 21, dose 2

2021-03-11

Symptoms: Last Friday & Saturday I had a headache, mild chills & couldnt get warm onFriday night. Since this is similar to what I experienced after vaccination Ive chalked it up to that. Feeling fine now.

Release 6 — day 42, dose 2

2021-04-01

Symptoms: Had a swollen gland in right side of neck ( opposite side of shot), but it is allergy season & just started using CPAP nasal pillow. Lasted a few days & now gone.

Release 11 — 12 months, dose 2

2022-02-18

Symptoms: At the end of October 2021, I had 4 blood clots removed from my lungs (2 in each). I did not have Covid or the flu at that time. My booster was postponed until December as a result, but I have had it.

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
SDChills ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDLymphadenopathy ✓ ✓ ✓
SDPulmonary thrombosis · · ✓
SROHeart rate increased ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓

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