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
-
2021-01-21
Dose 1 — Moderna
-
2021-01-30
Registered in v-safe
-
2021-01-30
Health check-in — day 7, dose 1Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tirednessAdult check-in
- 2021-02-04
- 2021-02-12
-
2021-02-18
Dose 2 — Moderna
- 2021-02-18
-
2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate increased, Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree 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
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
-
2021-02-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Chills, Headache, Fatigue or tirednessAdult check-in
- 2021-02-25
- 2021-03-04
-
2021-03-11
Survey response — day 21, dose 2MedDRA: Chills, Headache — Feeling: GoodFree 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
- 2021-03-18
- 2021-03-25
-
2021-04-01
Survey response — day 42, dose 2MedDRA: Lymphadenopathy — Feeling: GoodFree 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
- 2021-05-20
- 2021-08-19
-
2022-02-18
Survey response — 12 months, dose 2MedDRA: 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, HospitalizationFree 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
-
2022-02-18
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-02-22
-
2022-03-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-18 | Moderna |
Call center
| Reported | Outcome | VAERS-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
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
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
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Pulmonary thrombosis | · | · | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release