ZR3-20689-51167
3 vaccinations
9 coded responses
38 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 339 / FL
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-01
Registered in v-safe
-
2021-04-01
Dose 1 — Moderna
- 2021-04-02
- 2021-04-03
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-10
- 2021-04-15
- 2021-04-22
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2021-04-29
Dose 2 — Moderna
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2021-04-29
Survey response — day 0, dose 2MedDRA: Dental discomfort, Facial discomfort, Muscle tightness — Feeling: Fair · Fatigue or tirednessFree text: The front of my face and my upper teeth feel a little weird, so perhaps I am having some inflammation in my sinuses. My jaw also feels a little tight, like TMJ.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-30
Survey response — days 1–6 daily, dose 2MedDRA: Sinus congestion — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessFree text: Sinus congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-01
Survey response — days 1–6 daily, dose 2MedDRA: Conjunctivitis, Respiratory tract haemorrhage, Sinus congestion — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessFree text: Sinus congestion, some bloody discharge in mucus from right nostril, Conjunctivitis-like irritation of right eyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-02
Survey response — days 1–6 daily, dose 2MedDRA: Irritability, Memory impairment — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessFree text: Memory problems; irritabilityMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-06-10
- 2021-07-29
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2021-10-28
Survey response — 6 months, dose 2MedDRA: Fall, Haematoma — Feeling: GoodFree text: Tripped and fell - treated for hemotomaMedDRA releases: 2024-11 · check-in free text available
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2021-12-21
Dose 3 — Pfizer-BioNTech
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2021-12-21
Survey response — day 0, dose 3MedDRA: Facial discomfort, Hyperaesthesia teeth, Immediate post-injection reaction, Lip pain, Nasal discomfort, Reaction to previous exposure to any vaccine — Feeling: Good · Site: PainFree text: My face around nose and upper lip and upper teeth / jaw have felt a little funny / sensitive starting about an hour after getting booster ( very mild but similar to sensation I had after second shot).MedDRA releases: 2024-11 · check-in free text available
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2021-12-22
Survey response — days 1–6 daily, dose 3MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I had to fast the head of my annual cholesterol and blood sugar blood draw, so the fact that I did not eat normally today coupled with being freaked out by blood draws may account for why I am feeling a little off kilter today .MedDRA releases: 2024-11 · check-in free text available
- 2021-12-23
- 2021-12-24
- 2021-12-25
- 2021-12-26
- 2021-12-27
- 2021-12-28
- 2022-01-04
- 2022-01-11
- 2022-01-18
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2022-01-25
Survey response — day 35, dose 3MedDRA: Fatigue, Insomnia, Myalgia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I got a flu shot on January 22. While this may be unrelated to the flu shot, within 24 hours I developed abdominal muscular soreness, slight fatigue, insomnia.MedDRA releases: 2024-11 · check-in free text available
- 2022-02-01
- 2022-03-22
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2022-06-21
Survey response — 6 months, dose 3MedDRA: Chills, Fatigue, Headache, Myalgia, Paranasal sinus discomfort, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Self-medication — 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: Tested positive for Covid; severe sinus irritation which somewhat improved with OTC allergy meds (but could still smell / taste), runny nose, fever of 101.2, chills, headache, fatigue, some muscle aches.MedDRA releases: 2024-11 · check-in free text available
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2022-06-21
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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-06-22
-
2022-06-24
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-04-29 | Moderna | |
| 3 | 2021-12-21 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-21 | Successful 2022-06-24 |
Participant prefers to complete VAERS report online |
Free text
Release 8 — day 0, dose 2
Systemic reaction (other): The front of my face and my upper teeth feel a little weird, so perhaps I am having some inflammation in my sinuses. My jaw also feels a little tight, like TMJ.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Sinus congestion
Systemic reaction (other): Sinus congestion, some bloody discharge in mucus from right nostril, Conjunctivitis-like irritation of right eye
Systemic reaction (other): Memory problems; irritability
Release 10 — 6 months, dose 2
Symptoms: Tripped and fell - treated for hemotoma
Release 10 — day 0, dose 3
Systemic reaction (other): My face around nose and upper lip and upper teeth / jaw have felt a little funny / sensitive starting about an hour after getting booster ( very mild but similar to sensation I had after second shot).
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I had to fast the head of my annual cholesterol and blood sugar blood draw, so the fact that I did not eat normally today coupled with being freaked out by blood draws may account for why I am feeling a little off kilter today .
Release 11 — day 35, dose 3
Symptoms: I got a flu shot on January 22. While this may be unrelated to the flu shot, within 24 hours I developed abdominal muscular soreness, slight fatigue, insomnia.
Release 12 — 6 months, dose 3
Symptoms: Tested positive for Covid; severe sinus irritation which somewhat improved with OTC allergy meds (but could still smell / taste), runny nose, fever of 101.2, chills, headache, fatigue, some muscle aches.
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 | Chills | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Haematoma | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SRO | Conjunctivitis | ✓ | ✓ | ✓ |
| SRO | Dental discomfort | ✓ | ✓ | ✓ |
| SRO | Facial discomfort | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | · | · | ✓ |
| SRO | Hyperaesthesia teeth | · | · | ✓ |
| SRO | Immediate post-injection reaction | · | · | ✓ |
| SRO | Irritability | ✓ | ✓ | ✓ |
| SRO | Lip pain | · | · | ✓ |
| SRO | Memory impairment | ✓ | ✓ | ✓ |
| SRO | Muscle tightness | ✓ | ✓ | ✓ |
| SRO | Nasal discomfort | · | · | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Respiratory tract haemorrhage | ✓ | ✓ | ✓ |
| SRO | Sinus congestion | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release