4XY-15766-85470
2 vaccinations
4 coded responses
15 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 847 / UT
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Registered in v-safe
-
2020-12-30
Dose 1 — Moderna
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
-
2021-01-03
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Fatigue or tiredness, DiarrheaAdult check-in
-
2021-01-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Chills, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-01-06
-
2021-01-13
Survey response — day 14, dose 1MedDRA: Chills, Diarrhoea — Feeling: Good · Be unable to do your normal daily activitiesFree text: Severe chills and diarrhea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-13
Report sent to call center — day 14, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-21
-
2021-01-27
Dose 2 — Moderna
- 2021-02-20
- 2021-02-24
-
2021-03-03
Survey response — day 35, dose 2MedDRA: Diarrhoea, Fatigue, Rash — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Rash, fatigue, diarrhea, not sure if this is a flare up of some kind. I have had these all in past years.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
-
2021-04-29
Survey response — 3 months, dose 2MedDRA: Fatigue, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Huge fatigue, rashMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-29
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-15
-
2021-07-28
Survey response — 6 months, dose 2MedDRA: Angiopathy, Office visit, Vitamin B complex deficiency — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: I have blood vessels bursting on my right forearm. This is probably the 13th time it has happened. Same place always. Have seen primary care, dermatology and rheumatology. Low vitamin B found. All else good yet it continues. All started after vaccinMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-28
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-06
-
2021-08-10
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-27 | Moderna |
Call center
3 call center cases
2 successful · 1 priority 2/3 (triaged and no follow up)
VAERS report filed, before or during a call: 2
Free text
Release 1 — day 14, dose 1
Symptoms: Severe chills and diarrhea.
Release 4 — day 35, dose 2
Symptoms: Rash, fatigue, diarrhea, not sure if this is a flare up of some kind. I have had these all in past years.
Release 8 — 3 months, dose 2
Symptoms: Huge fatigue, rash
Release 9 — 6 months, dose 2
Symptoms: I have blood vessels bursting on my right forearm. This is probably the 13th time it has happened. Same place always. Have seen primary care, dermatology and rheumatology. Low vitamin B found. All else good yet it continues. All started after vaccin cut off by CDC
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 | Angiopathy | ✓ | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Vitamin B complex deficiency | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release