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ZQS-13607-42366

2 vaccinations 9 coded responses 15 check-ins 9 free-text entries 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
950 / CA
Registered
2021-05-06
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-08
    Dose 1 — Moderna
  2. 2021-05-06
    Registered in v-safe
  3. 2021-05-06
    Dose 2 — Moderna
  4. 2021-05-06
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  5. 2021-05-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue, Tremor — Feeling: Fair · Site: Pain · Fatigue or tiredness
    Free text: Got trembly and tired
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-05-08
    Survey response — days 1–6 daily, dose 2
    MedDRA: Arthralgia — Feeling: Good · Fatigue or tiredness
    Free text: Very mild joint pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-05-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  9. 2021-05-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oedema — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Edema
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-13
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-05-20
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  12. 2021-05-27
    Survey response — day 21, dose 2
    MedDRA: Arthralgia, Palpitations — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Sore joints racing heart
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-06-03
    Survey response — day 28, dose 2
    MedDRA: Back pain, Peripheral swelling — Feeling: Fair
    Free text: Just swelling legs low back pain not sure its related
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-06-10
    Survey response — day 35, dose 2
    MedDRA: Arthralgia, Fatigue, Oedema — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Edema tired possibly kidney stone joint pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-06-17
    Survey response — day 42, dose 2
    MedDRA: Oedema peripheral — Feeling: Fair
    Free text: Edema legs
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-08-05
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  17. 2021-11-04
    Survey response — 6 months, dose 2
    MedDRA: Arthralgia, Depression, Nephrolithiasis, Renal stone removal, Stress — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Kidney stones so removal alf those.. sore joints but don't know if that's just stress. The only other thing is really bad depression not sure that's related to vaccine it's been a stressful year and a half!!! Right???!!!
    MedDRA releases: 2024-11 · check-in free text available
  18. 2022-05-06
    Survey response — 12 months, dose 2
    MedDRA: Eye disorder, Heart rate increased, Ligament pain, Myalgia, Tendon pain — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    Free text: Spots in eyes, jigiment tendon muscle pain extreme fast heart beat
    MedDRA releases: 2024-11 · check-in free text available
  19. 2022-05-06
    Report sent to call center — 12 months, dose 2
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  20. 2022-05-09

Vaccinations

DoseDateManufacturerCo-administered
12021-04-08Moderna
22021-05-06Moderna

Call center

ReportedOutcomeVAERS-related outcome
2022-05-06 Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-07

Systemic reaction (other): Got trembly and tired

2021-05-08

Systemic reaction (other): Very mild joint pain

2021-05-12

Systemic reaction (other): Edema

Release 8 — day 21, dose 2

2021-05-27

Symptoms: Sore joints racing heart

Release 8 — day 28, dose 2

2021-06-03

Symptoms: Just swelling legs low back pain not sure its related

Release 9 — day 35, dose 2

2021-06-10

Symptoms: Edema tired possibly kidney stone joint pain

Release 9 — day 42, dose 2

2021-06-17

Symptoms: Edema legs

Release 10 — 6 months, dose 2

2021-11-04

Symptoms: Kidney stones so removal alf those.. sore joints but don't know if that's just stress. The only other thing is really bad depression not sure that's related to vaccine it's been a stressful year and a half!!! Right???!!!

Release 11 — 12 months, dose 2

2022-05-06

Symptoms: Spots in eyes, jigiment tendon muscle pain extreme fast heart beat

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDBack pain ✓ ✓ ✓
SDDepression · · ✓
SDEye disorder · · ✓
SDFatigue ✓ ✓ ✓
SDHeart rate increased · · ✓
SDLigament pain · · ✓
SDMyalgia · · ✓
SDNephrolithiasis · · ✓
SDOedema ✓ ✓ ✓
SDOedema peripheral ✓ ✓ ✓
SDPalpitations ✓ ✓ ✓
SDPeripheral swelling ✓ ✓ ✓
SDRenal stone removal · · ✓
SDStress · · ✓
SDTendon pain · · ✓
SROArthralgia ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROOedema ✓ ✓ ✓
SROTremor ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release