ZC8-13330-40207
4 vaccinations
17 coded responses
35 check-ins
16 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 759 / TX
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
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2021-01-11
Dose 1 — Moderna
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2021-01-17
Registered in v-safe
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2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Axillary pain, Submaxillary gland enlargement — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches · Be unable to do your normal daily activitiesFree text: Axillary swelling and moderate pain (in arm-pit)located on same arm as injection. (Left arm)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-17
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2021-01-18
Survey response — day 7, dose 1MedDRA: Axillary pain — Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Axillary pain in injected armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-18
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-03
Survey response — day 21, dose 1MedDRA: Fatigue, Muscle fatigue, Muscular weakness, Pain, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Muscle fatigue in both upper arms, similar to after intense weightlifting. Muscle weakness in both arms starting in past 24hrs. Full body aches including neck and thoracic spine area. Noticeably more, painfully sore deltoids. Fatigue. Covid negative.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-08
Dose 2 — Moderna
- 2021-02-08
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2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-02-12
- 2021-02-19
- 2021-02-23
- 2021-03-03
- 2021-03-08
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2021-03-15
Survey response — day 35, dose 2MedDRA: Cellulitis — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Cellulitis skin infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-22
- 2021-03-23
- 2021-05-12
- 2021-08-09
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2021-12-14
Dose 3 — ModernaCo-administered: Flu
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2021-12-15
Survey response — days 1–6 daily, dose 3MedDRA: Dysgeusia, Taste disorder — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Altered/ bitter tasteMedDRA releases: 2024-11 · check-in free text available
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2021-12-16
Survey response — days 1–6 daily, dose 3MedDRA: SARS-CoV-2 test negative, Taste disorder — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sudden altered tastes perception 33hrs post booster with negative covid test. Loss of bitter detection and other taste changes.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-18
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2021-12-20
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-12-21
Survey response — day 7, dose 3MedDRA: Rhinorrhoea — Feeling: Good · HeadacheFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
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2021-12-28
Survey response — day 14, dose 3MedDRA: Rash — Feeling: GoodFree text: Rash on injection forearm arm 13 days post moderna booster. Additional rash on knuckles developed later in same day.MedDRA releases: 2024-11 · check-in free text available
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2022-01-06
Survey response — day 21, dose 3MedDRA: Epistaxis — Feeling: FairFree text: First occurrence of Nosebleeds, 2 consecutive days.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-15
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2022-01-25
Survey response — day 42, dose 3MedDRA: Body temperature increased — Feeling: GoodFree text: 99.4 Temp for 4 days (Typical Normal Temp 97.0-98.0). No other symptoms.MedDRA releases: 2024-11 · check-in free text available
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2022-03-17
Survey response — 3 months, dose 3MedDRA: Epistaxis, Facial pain, Fatigue, Migraine, Migraine with aura, Paranasal sinus discomfort, Pyrexia, Sinusitis, 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 visitFree text: Facial pain Sinus pressure Nose bleeds (first time in life) Vertigo Migraine visual aurora Fatigue Migraines Fever Sinusitis requiring antibioticsMedDRA releases: 2024-11 · check-in free text available
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2022-03-17
Report sent to call center — 3 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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-03-21
Call successfulCompleted over the phone
- 2022-03-22
- 2022-06-20
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2022-11-18
Dose 4 — ModernaCo-administered: Flu
- 2022-11-18
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2022-11-19
Survey response — days 1–6 daily, dose 4MedDRA: Axillary pain, Hyperhidrosis, Lymphadenopathy, Vision blurred — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend schoolFree text: Severe axillary pain in arm of injection site with swollen lymph nodes in left underarm. Also blurred vision occurring this afternoon and sweats.MedDRA releases: 2024-11 · check-in free text available
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2022-11-20
Survey response — days 1–6 daily, dose 4MedDRA: Discomfort, Eye pain, Lymphadenopathy, Vision blurred — Feeling: Fair · Site: PainFree text: Swollen lymph nodes (arm pit) in arm of injection, facial pressure, blurred vision, eye pain.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-23
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2022-11-26
Survey response — day 7, dose 4MedDRA: Discomfort, Epistaxis, Headache, Photopsia, Visual impairment — Feeling: FairFree text: Sudden flashing light in right eye. Seeing large black spot obscuring vision. Headache, facial pressure. Nose bleeds and vision changes (seeing flashing lights obscuring vision) did not occur at any point in life until after the moderna vaccine/covidMedDRA releases: 2024-11 · check-in free text available
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2022-12-02
Survey response — day 14, dose 4MedDRA: Epistaxis — Feeling: FairFree text: Infrequent NosebleedsMedDRA releases: 2024-11 · check-in free text available
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2022-12-16
Survey response — day 28, dose 4MedDRA: Pruritus, Rash, SARS-CoV-2 test positive, Skin warm, Urticaria — Feeling: FairFree text: Developed rash 2 days before positive Covid test. Positive test 8 July 2022. Spotted appearance, hot to touch and itchy on abdomen. Rash did not disappear like typical hive reaction. ( 4 days ago rash spots reappeared in same location as before).MedDRA releases: 2024-11 · check-in free text available
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2023-02-17
Survey response — 3 months, dose 4MedDRA: Cough, Discomfort, Ear pain, Fatigue, Influenza virus test negative, Oropharyngeal pain, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — 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 · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-02-17
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-02-20
- 2023-02-20
- 2023-02-20
- 2023-05-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-12-14 | Moderna | Flu |
| 4 | 2022-11-18 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-17 | Unsuccessful | |
| 2021-01-18 | Unsuccessful | |
| 2021-03-15 | Unsuccessful | |
| 2022-03-17 | Successful 2022-03-21 |
Completed over the phone |
| 2023-02-17 | Unsuccessful |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Axillary swelling and moderate pain (in arm-pit)located on same arm as injection. (Left arm)
Release 2 — day 7, dose 1
Systemic reaction (other): Axillary pain in injected arm
Release 3 — day 21, dose 1
Symptoms: Muscle fatigue in both upper arms, similar to after intense weightlifting. Muscle weakness in both arms starting in past 24hrs. Full body aches including neck and thoracic spine area. Noticeably more, painfully sore deltoids. Fatigue. Covid negative. cut off by CDC
Release 5 — day 35, dose 2
Symptoms: Cellulitis skin infection
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Altered/ bitter taste
Systemic reaction (other): Sudden altered tastes perception 33hrs post booster with negative covid test. Loss of bitter detection and other taste changes.
Release 10 — day 7, dose 3
Systemic reaction (other): Runny nose
Release 10 — day 14, dose 3
Symptoms: Rash on injection forearm arm 13 days post moderna booster. Additional rash on knuckles developed later in same day.
Release 10 — day 21, dose 3
Symptoms: First occurrence of Nosebleeds, 2 consecutive days.
Release 11 — day 42, dose 3
Symptoms: 99.4 Temp for 4 days (Typical Normal Temp 97.0-98.0). No other symptoms.
Release 11 — 3 months, dose 3
Symptoms: Facial pain Sinus pressure Nose bleeds (first time in life) Vertigo Migraine visual aurora Fatigue Migraines Fever Sinusitis requiring antibiotics
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Severe axillary pain in arm of injection site with swollen lymph nodes in left underarm. Also blurred vision occurring this afternoon and sweats.
Systemic reaction (other): Swollen lymph nodes (arm pit) in arm of injection, facial pressure, blurred vision, eye pain.
Release 12 — day 7, dose 4
Systemic reaction (other): Sudden flashing light in right eye. Seeing large black spot obscuring vision. Headache, facial pressure. Nose bleeds and vision changes (seeing flashing lights obscuring vision) did not occur at any point in life until after the moderna vaccine/covid cut off by CDC
Release 12 — day 14, dose 4
Symptoms: Infrequent Nosebleeds
Release 12 — day 28, dose 4
Symptoms: Developed rash 2 days before positive Covid test. Positive test 8 July 2022. Spotted appearance, hot to touch and itchy on abdomen. Rash did not disappear like typical hive reaction. ( 4 days ago rash spots reappeared in same location as before).
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 | Body temperature increased | · | · | ✓ |
| SD | Cellulitis | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Discomfort | · | · | ✓ |
| SD | Ear pain | · | · | ✓ |
| SD | Epistaxis | · | · | ✓ |
| SD | Facial pain | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Migraine with aura | · | · | ✓ |
| SD | Muscle fatigue | ✓ | ✓ | ✓ |
| SD | Muscular weakness | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Skin warm | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SD | Vertigo | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Discomfort | · | · | ✓ |
| SRO | Dysgeusia | · | · | ✓ |
| SRO | Epistaxis | · | · | ✓ |
| SRO | Eye pain | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Hyperhidrosis | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Photopsia | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
| SRO | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Submaxillary gland enlargement | ✓ | ✓ | ✓ |
| SRO | Taste disorder | · | · | ✓ |
| SRO | Vision blurred | · | · | ✓ |
| SRO | Visual impairment | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release