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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

  1. 2021-03-18
    Dose 1 — Moderna
  2. 2021-04-17
    Dose 2 — Moderna
  3. 2021-04-18
    Registered in v-safe
  4. 2021-04-18
    Survey response — days 1–6 daily, dose 2
    MedDRA: 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 activities
    Free text: History of stroke blood clot from mrsa
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-19
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work
    Free text: I had a stroke /blood clot from MRSA and phnemonia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Swelling, Itching · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  7. 2021-04-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  8. 2021-04-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Good
    Free 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
  9. 2021-04-24
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Itching · Fatigue or tiredness
    Adult check-in
  10. 2021-05-04
    Survey response — day 14, dose 2
    MedDRA: Arthralgia, Headache, Injection site pain, Pain, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free 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
  11. 2021-05-10
    Survey response — day 21, dose 2
    MedDRA: Headache, Pain, Pyrexia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Horrible headaches, 3-4 days straight fever, and body aches.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-15
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  13. 2021-06-02
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  14. 2022-04-19
    Survey response — 12 months, dose 2
    MedDRA: 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 visit
    Free 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
  15. 2022-04-19
    Report sent to call center — 12 months, dose 2
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
  16. 2022-04-21

Vaccinations

DoseDateManufacturerCo-administered
12021-03-18Moderna
22021-04-17Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): History of stroke blood clot from mrsa

2021-04-19

Systemic reaction (other): I had a stroke /blood clot from MRSA and phnemonia

2021-04-23

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

2021-05-04

Symptoms: Fever, headache , joint pain, body aches low throbbing pan in my arm at the injection site.

Release 8 — day 21, dose 2

2021-05-10

Symptoms: Horrible headaches, 3-4 days straight fever, and body aches.

Release 11 — 12 months, dose 2

2022-04-19

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDChest discomfort · · ✓
SDHeadache ✓ ✓ ✓
SDInjection site pain ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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