Z7Y-28151-97426
3 vaccinations
7 coded responses
29 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 301 / GA
- Registered
- 2021-01-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Registered in v-safe
-
2021-01-27
Dose 1 — Moderna
- 2021-01-27
-
2021-01-28
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: Good · Site: Pain · Chills, Fatigue or tirednessFree text: Dont know if these are related to vacinne because I have some of these sypmtoms anywaysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-29
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia — Feeling: Good · Joint painsFree text: Wrist painsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-30
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-11
- 2021-02-17
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Diarrhoea — Feeling: Good · DiarrheaFree text: Diearrhea was yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-05-26
- 2021-08-25
-
2021-09-21
Dose 3 — Moderna
-
2021-10-27
Survey response — day 35, dose 3MedDRA: Asthenia, Dizziness, Emergency care, Head discomfort, Hospitalisation, Medical counselling, Myalgia, Ocular discomfort, Office visit, Swelling, Vena cava thrombosis — Feeling: Poor · Be unable to work or attend school, 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: Symptoms: SVC bloodclot, extreme upper body swelling, pressure in head and eyes, dizzy, muscle pain, fatigue, muscle weakness, · Healthcare visit (other): Family Dr 3times, calls, 8 days hospitalized after 2nd er tripMedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Report sent to call center — day 35, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
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2021-11-02
Survey response — day 42, dose 3MedDRA: Haematoma, Haematoma evacuation, Myalgia, Neuralgia, Postoperative wound infection, Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Muscles & nerves hurt all over my neck and upper body. Have infection now where hematoma was that had to be lanced last week · Healthcare visit (other): Have appointment tomorrow and ThursdatMedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Report sent to call center — day 42, dose 3Be 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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2021-12-21
Survey response — 3 months, dose 3MedDRA: Adverse reaction — Feeling: Fair · Be unable to do your normal daily activitiesFree text: All symptoms still going onMedDRA releases: 2024-11 · check-in free text available
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2022-03-22
Survey response — 6 months, dose 3MedDRA: Cardiac ventricular thrombosis, Collateral circulation, Office visit — Feeling: Poor · Be unable to work or attend school, 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: Symptoms: Many collateral curculations around heart clot · Healthcare visit (other): PcpMedDRA releases: 2024-11 · check-in free text available
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2022-03-22
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-03-23
Call successfulCompleted over the phone
- 2022-09-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-09-21 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-27 | Successful | Reported to VAERS during previous contact from GDIT |
| 2021-11-02 | Successful | Reported to VAERS during previous contact from GDIT |
| 2022-03-22 | Successful 2022-03-23 |
Completed over the phone |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Dont know if these are related to vacinne because I have some of these sypmtoms anyways
Systemic reaction (other): Wrist pains
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Diearrhea was yesterday
Release 10 — day 35, dose 3
Symptoms: SVC bloodclot, extreme upper body swelling, pressure in head and eyes, dizzy, muscle pain, fatigue, muscle weakness,
Healthcare visit (other): Family Dr 3times, calls, 8 days hospitalized after 2nd er trip
Release 10 — day 42, dose 3
Symptoms: Muscles & nerves hurt all over my neck and upper body. Have infection now where hematoma was that had to be lanced last week
Healthcare visit (other): Have appointment tomorrow and Thursdat
Release 10 — 3 months, dose 3
Symptoms: All symptoms still going on
Release 11 — 6 months, dose 3
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 |
|---|---|---|---|---|
| HCVO | Emergency care | · | · | ✓ |
| HCVO | Hospitalisation | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Adverse reaction | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Cardiac ventricular thrombosis | · | · | ✓ |
| SD | Collateral circulation | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Haematoma | · | · | ✓ |
| SD | Haematoma evacuation | · | · | ✓ |
| SD | Head discomfort | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SD | Ocular discomfort | · | · | ✓ |
| SD | Postoperative wound infection | · | · | ✓ |
| SD | Swelling | · | · | ✓ |
| SD | Vena cava thrombosis | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release