ZJD-13506-63298
5 vaccinations
11 coded responses
51 check-ins
10 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 992 / WA
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Dose 1 — Moderna
-
2021-01-30
Registered in v-safe
- 2021-01-30
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2021-01-31
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · None · Be unable to do your normal daily activitiesAdult check-in
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2021-02-01
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessAdult check-in
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-12
- 2021-02-19
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2021-02-26
Dose 2 — Moderna
- 2021-02-26
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2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My normal temp is 97.6 so when it gets to 99 or 102 yesterday, that's highMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Hypersomnia — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Mild. But skept late. Too tired to get uoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-03
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2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-05
- 2021-03-12
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2021-03-19
Survey response — day 21, dose 2MedDRA: Dyspnoea — Feeling: Good · Be unable to do your normal daily activitiesFree text: Shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-28
- 2021-04-02
- 2021-04-09
- 2021-05-28
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2021-08-27
Survey response — 6 months, dose 2MedDRA: Dyspnoea, Fatigue, SARS-CoV-2 test negative, Wheezing — Feeling: Good · Be unable to do your normal daily activitiesFree text: Fatigue, shortness of breath, wheezing. Negative Covid-19 testMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-11-04
Dose 3 — Moderna
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2022-02-26
Survey response — 12 months, dose 2MedDRA: Carotid artery dissection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I have several carotid artery dissections in my head. I doubt it's caused by the immunizationsMedDRA releases: 2024-11 · check-in free text available
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2022-02-26
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-03-21
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2022-05-11
Dose 4 — Moderna
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2022-05-12
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-14
- 2022-05-15
- 2022-05-16
- 2022-05-17
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2022-05-18
Survey response — day 7, dose 4MedDRA: Concussion, Dizziness, Gait disturbance — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Dizzy, walked into a wall. Have a concussionMedDRA releases: 2024-11 · check-in free text available
- 2022-05-25
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2022-06-01
Survey response — day 21, dose 4MedDRA: Body temperature increased, Concussion, Confusional state, Dyspnoea, Fall, Haemorrhage, Nausea, Pre-existing disease — Feeling: GoodFree text: I fell on a raised sidewalk, got a concussion bump on the head. Walked home bleeding. Nausea, abd a lot of confusion. Have to be careful due to aneurysms and Arterial dissections. Then got a frver of 100 degrees. Lasted several days. Now sobMedDRA releases: 2024-11 · check-in free text available
- 2022-06-09
- 2022-06-15
- 2022-06-22
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2022-08-13
Survey response — 3 months, dose 4MedDRA: Arterial disorder, Condition aggravated, Medical procedure, Pre-existing disease, Presyncope — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Vaso vagus reaction from procedure. Affected my arteries in my brain, I have FMD, and it affected itMedDRA releases: 2024-11 · check-in free text available
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2022-10-25
Dose 5 — Pfizer-BioNTech
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2022-10-26
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-10-27
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Joint pains, Fatigue or tirednessAdult check-in
- 2022-10-28
- 2022-10-29
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2022-10-30
Health check-in — days 1–6 daily, dose 5Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-31
- 2022-11-01
- 2022-11-08
- 2022-11-15
- 2022-11-22
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2022-11-29
Survey response — day 35, dose 5MedDRA: Asthenia, Exposure to SARS-CoV-2, Malaise, Oropharyngeal pain, Pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: I was exposed to covid, and I am feeling a little punky. Sore throat, no energy, achy. But it's not badMedDRA releases: 2024-11 · check-in free text available
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2022-12-06
Survey response — day 42, dose 5MedDRA: Headache, Irritable bowel syndrome, Muscle spasms, Nausea, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: IBS. cramping, intermittent fever, horrible constant headaches and nausea. Negative for CovidMedDRA releases: 2024-11 · check-in free text available
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2022-12-06
Report sent to call center — day 42, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-07
- 2022-12-07
- 2023-01-24
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2023-04-25
Survey response — 6 months, dose 5MedDRA: Aneurysm, Brain fog, Condition aggravated, Dyspnoea, Pre-existing disease, Pulmonary mass — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-04-25
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-04-26
- 2023-04-26
- 2023-04-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-11-04 | Moderna | No |
| 4 | 2022-05-11 | Moderna | No |
| 5 | 2022-10-25 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-26 | Unsuccessful | |
| 2022-12-06 | Unsuccessful | |
| 2023-04-25 | Unsuccessful |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): My normal temp is 97.6 so when it gets to 99 or 102 yesterday, that's high
Systemic reaction (other): Mild. But skept late. Too tired to get uo
Release 5 — day 21, dose 2
Symptoms: Shortness of breath
Release 9 — 6 months, dose 2
Symptoms: Fatigue, shortness of breath, wheezing. Negative Covid-19 test
Release 11 — 12 months, dose 2
Symptoms: I have several carotid artery dissections in my head. I doubt it's caused by the immunizations
Release 11 — day 7, dose 4
Systemic reaction (other): Dizzy, walked into a wall. Have a concussion
Release 11 — day 21, dose 4
Symptoms: I fell on a raised sidewalk, got a concussion bump on the head. Walked home bleeding. Nausea, abd a lot of confusion. Have to be careful due to aneurysms and Arterial dissections. Then got a frver of 100 degrees. Lasted several days. Now sob
Release 12 — 3 months, dose 4
Symptoms: Vaso vagus reaction from procedure. Affected my arteries in my brain, I have FMD, and it affected it
Release 12 — day 35, dose 5
Symptoms: I was exposed to covid, and I am feeling a little punky. Sore throat, no energy, achy. But it's not bad
Release 12 — day 42, dose 5
Symptoms: IBS. cramping, intermittent fever, horrible constant headaches and nausea. Negative for Covid
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 | Aneurysm | · | · | ✓ |
| SD | Arterial disorder | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Carotid artery dissection | · | · | ✓ |
| SD | Concussion | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Confusional state | · | · | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Haemorrhage | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Irritable bowel syndrome | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Medical procedure | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Presyncope | · | · | ✓ |
| SD | Pulmonary mass | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | · | ✓ |
| SD | Wheezing | ✓ | · | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Concussion | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Gait disturbance | · | · | ✓ |
| SRO | Hypersomnia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release