ZKT-26094-09456
3 vaccinations
9 coded responses
34 check-ins
9 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 133 / NY
- Registered
- 2021-03-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Registered in v-safe
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2021-03-03
Dose 1 — Moderna
- 2021-03-03
- 2021-03-04
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2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Hypersensitivity, Oropharyngeal pain — Feeling: Good · Site: PainFree text: Mild sore throat - but I have allergies so its probably just thatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-17
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2021-03-24
Survey response — day 21, dose 1MedDRA: Depression — Feeling: GoodFree text: I had a strange bout of depression last week that was kind of uncharacteristic. Its mostly faded now but was kind of odd.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-31
Dose 2 — Moderna
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2021-03-31
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Nausea · Be unable to workAdult check-in
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2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness, Nausea · Be unable to workAdult check-in
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2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Anxiety — Feeling: Good · Site: Pain, RednessFree text: AnxietyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
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2021-04-14
Survey response — day 14, dose 2MedDRA: Abdominal pain, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: A few days ago I started having pain on the right side of my abdomen below the chest that won't go away. I have no idea if this has anything to do with the vaccine or if it's just a coincidence. · Healthcare visit (other): Scheduled an appointment for next MondayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-21
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2021-04-28
Survey response — day 28, dose 2MedDRA: Abdominal discomfort, Condition aggravated, Dyspepsia, Flank pain, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: A lot of heartburn and digestive upset - pain on the right side is getting better, but my acid reflux has gotten really intense. This is probably coincidenceMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-05
- 2021-05-12
- 2021-06-30
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2021-11-09
Dose 3 — Moderna
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2021-11-10
Survey response — days 1–6 daily, dose 3MedDRA: Brain fog, Decreased appetite — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Brain fog, lack of hungerMedDRA releases: 2024-11 · check-in free text available
- 2021-11-11
- 2021-11-12
- 2021-11-13
- 2021-11-15
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2021-11-16
Survey response — day 7, dose 3MedDRA: Anxiety — Feeling: FairFree text: AnxietyMedDRA releases: 2024-11 · check-in free text available
- 2021-11-23
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2021-11-30
Survey response — day 21, dose 3MedDRA: Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I developed a rash last Friday that has come and gone. It's small and appears on my neck, back and stomachMedDRA releases: 2024-11 · check-in free text available
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2021-11-30
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-12-08
Survey response — day 28, dose 3MedDRA: Autoimmune thyroiditis, Mechanical urticaria, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: After developing a rash two weeks after the vaccine that comes and goes on certain parts of my body, I've been diagnosed with Dermatographia. I have Hashimoto's thyroid disease and know someone else who experienced the same - Please study the link.MedDRA releases: 2024-11 · check-in free text available
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2021-12-08
Report sent to call center — day 28, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-12-09
Call successfulReported to VAERS during previous contact from GDIT
- 2021-12-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-31 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-14 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-04-28 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-11-30 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-12-08 | Successful 2021-12-09 |
Reported to VAERS during previous contact from GDIT |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Mild sore throat - but I have allergies so its probably just that
Release 6 — day 21, dose 1
Symptoms: I had a strange bout of depression last week that was kind of uncharacteristic. Its mostly faded now but was kind of odd.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Anxiety
Release 7 — day 14, dose 2
Symptoms: A few days ago I started having pain on the right side of my abdomen below the chest that won't go away. I have no idea if this has anything to do with the vaccine or if it's just a coincidence.
Healthcare visit (other): Scheduled an appointment for next Monday
Release 8 — day 28, dose 2
Symptoms: A lot of heartburn and digestive upset - pain on the right side is getting better, but my acid reflux has gotten really intense. This is probably coincidence
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Brain fog, lack of hunger
Release 10 — day 7, dose 3
Systemic reaction (other): Anxiety
Release 10 — day 21, dose 3
Symptoms: I developed a rash last Friday that has come and gone. It's small and appears on my neck, back and stomach
Release 10 — day 28, dose 3
Symptoms: After developing a rash two weeks after the vaccine that comes and goes on certain parts of my body, I've been diagnosed with Dermatographia. I have Hashimoto's thyroid disease and know someone else who experienced the same - Please study the link. cut off by CDC
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Abdominal pain | ✓ | ✓ | ✓ |
| SD | Autoimmune thyroiditis | · | · | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Depression | ✓ | ✓ | ✓ |
| SD | Dyspepsia | ✓ | ✓ | ✓ |
| SD | Flank pain | ✓ | ✓ | ✓ |
| SD | Mechanical urticaria | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Rash | · | · | ✓ |
| SRO | Anxiety | ✓ | ✓ | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Decreased appetite | · | · | ✓ |
| SRO | Hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release