ZWA-14797-66496
2 vaccinations
6 coded responses
11 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 900 / CA
- Registered
- 2021-04-18
- Relationship
- Self
- Race
- Native Hawaiian or other Pacific Islander
- Ethnicity
- N/A
Timeline
-
2021-03-18
Dose 1 — Moderna
-
2021-04-17
Dose 2 — Moderna
-
2021-04-18
Registered in v-safe
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2021-04-18
Survey response — days 1–6 daily, dose 2MedDRA: Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: History of stroke blood clot from mrsaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to workFree text: I had a stroke /blood clot from MRSA and phnemoniaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-04-22
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: 2012 I had MRSA that caused a stroke or blood clot to my brain and survived.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
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2021-05-04
Survey response — day 14, dose 2MedDRA: Arthralgia, Headache, Injection site pain, Pain, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Fever, headache , joint pain, body aches low throbbing pan in my arm at the injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-10
Survey response — day 21, dose 2MedDRA: Headache, Pain, Pyrexia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: Horrible headaches, 3-4 days straight fever, and body aches.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-15
- 2021-06-02
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2022-04-19
Survey response — 12 months, dose 2MedDRA: Chest discomfort — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Under my left rib I felt swelling like a small bubble forming, then a pop within a 5 second period. Same symptoms I felt shortly after taking my vaccinations.MedDRA releases: 2024-11 · check-in free text available
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2022-04-19
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
- 2022-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-17 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): History of stroke blood clot from mrsa
Systemic reaction (other): I had a stroke /blood clot from MRSA and phnemonia
Systemic reaction (other): 2012 I had MRSA that caused a stroke or blood clot to my brain and survived.
Release 8 — day 14, dose 2
Symptoms: Fever, headache , joint pain, body aches low throbbing pan in my arm at the injection site.
Release 8 — day 21, dose 2
Symptoms: Horrible headaches, 3-4 days straight fever, and body aches.
Release 11 — 12 months, dose 2
Symptoms: Under my left rib I felt swelling like a small bubble forming, then a pop within a 5 second period. Same symptoms I felt shortly after taking my vaccinations.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release