ZVD-30004-56933
4 vaccinations
9 coded responses
44 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 670 / KS
- Registered
- 2021-03-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-09
Registered in v-safe
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2021-03-10
Dose 1 — Moderna
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2021-03-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · HeadacheAdult check-in
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2021-03-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-14
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2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Chest discomfort, Chest pain, Neck pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: Last evening I had tightness in my chest & chest pains that extended up into my neck. They went away after an hour of lying down & resting.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Chest discomfort, Chest pain, Ear pain, Painful respiration — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Mild chest pains & tightening. Seems to continue up into my right ear. Kind of hurts to breathe deeply.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Survey response — day 7, dose 1MedDRA: Tachycardia — Feeling: Fair · Fatigue or tirednessFree text: Tachycardia (resting heart rate 117)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Survey response — day 14, dose 1MedDRA: Atrial fibrillation, Pre-existing disease, Tachycardia — Feeling: GoodFree text: I have had tachycardia twice and atrial fibrillation once (I have the Kardia EKG pads). Im going to keep monitoring. I dont have a history of heart problems, although I have had chemo and Herceptin in the past.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-31
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2021-04-07
Dose 2 — Moderna
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2021-04-07
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: GoodFree text: It has only been about an hour since I got the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-07-07
- 2021-10-06
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2021-10-08
Dose 3 — Moderna
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
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2022-01-07
Survey response — 3 months, dose 3MedDRA: Cough, Dysphonia, Oropharyngeal pain, Respiratory tract infection, Rhinorrhoea — Feeling: Good · 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: I have had several respiratory infections with sore throat, runny nose, coughing, and hoarsenessMedDRA releases: 2024-11 · check-in free text available
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2022-01-07
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-01-10
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-10
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2022-04-19
Dose 4 — Moderna
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2022-04-20
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, NauseaAdult check-in
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2022-04-21
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-04-22
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
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2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-05-03
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2022-05-10
Survey response — day 21, dose 4MedDRA: Joint stiffness, Joint swelling, Muscle spasms, Musculoskeletal stiffness, Paraesthesia, Peripheral swelling — Feeling: GoodFree text: Leg cramps and swollen ankles, which I have not previously had. This could be unrelated but I thought I should report it and let you decide whether or not it is relevant. The swollen ankles & feet also tingle & feel stiff. Had for several days.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-07-19
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2022-10-20
Survey response — 6 months, dose 4MedDRA: Cough, Fatigue, Headache, Respiratory disorder — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Respiratory illness, fatigue, headache, coughMedDRA releases: 2024-11 · check-in free text available
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2023-04-19
Survey response — 12 months, dose 4MedDRA: Dizziness, Ear infection, Nausea, Office visit, Sinusitis, Wheezing — Feeling: Good · 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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2023-04-19
Report sent to call center — 12 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-04-20
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2023-04-21
Callback requested for10:30AM ET
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2023-04-21
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Moderna | |
| 2 | 2021-04-07 | Moderna | |
| 3 | 2021-10-08 | Moderna | No |
| 4 | 2022-04-19 | Moderna | No |
Call center
2 call center cases
2 successful
VAERS report filed, before or during a call: 1
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Last evening I had tightness in my chest & chest pains that extended up into my neck. They went away after an hour of lying down & resting.
Systemic reaction (other): Mild chest pains & tightening. Seems to continue up into my right ear. Kind of hurts to breathe deeply.
Release 5 — day 7, dose 1
Systemic reaction (other): Tachycardia (resting heart rate 117)
Release 6 — day 14, dose 1
Symptoms: I have had tachycardia twice and atrial fibrillation once (I have the Kardia EKG pads). Im going to keep monitoring. I dont have a history of heart problems, although I have had chemo and Herceptin in the past.
Release 7 — day 0, dose 2
Systemic reaction (other): It has only been about an hour since I got the shot.
Release 10 — 3 months, dose 3
Symptoms: I have had several respiratory infections with sore throat, runny nose, coughing, and hoarseness
Release 11 — day 21, dose 4
Symptoms: Leg cramps and swollen ankles, which I have not previously had. This could be unrelated but I thought I should report it and let you decide whether or not it is relevant. The swollen ankles & feet also tingle & feel stiff. Had for several days.
Release 12 — 6 months, dose 4
Symptoms: Respiratory illness, fatigue, headache, cough
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 | Atrial fibrillation | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Dysphonia | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Joint stiffness | · | · | ✓ |
| SD | Joint swelling | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Musculoskeletal stiffness | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Respiratory tract infection | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Tachycardia | ✓ | ✓ | ✓ |
| SD | Wheezing | · | · | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Painful respiration | ✓ | ✓ | ✓ |
| SRO | Tachycardia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release