6XN-13309-30000
2 vaccinations
4 coded responses
25 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 840 / UT
- Registered
- 2021-10-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-10-05
Registered in v-safe
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2021-10-05
Dose 1 — Moderna
-
2021-10-05
Health check-in — day 0, dose 1Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, NauseaAdult check-in
-
2021-10-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-10-07
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tirednessAdult check-in
-
2021-10-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2021-10-09
- 2021-10-10
- 2021-10-11
-
2021-10-12
Survey response — day 7, dose 1MedDRA: Cough — Feeling: GoodFree text: Slight coughMedDRA releases: 2024-11 · check-in free text available
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2021-10-19
Survey response — day 14, dose 1MedDRA: Chills, Cough, Fatigue, Heart rate increased, Malaise, Pain, Respiratory tract congestion, SARS-CoV-2 test positive, Sinus pain — 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 came down with Covid symptoms 10/13 and tested positive 10/14. Symptoms were severe body aches, chills, fatigue, congestion and sinus pain, high heart rate, mild cough.MedDRA releases: 2024-11 · check-in free text available
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2021-10-19
Report sent to call center — day 14, dose 1Be 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)
- 2021-10-21
- 2021-10-26
-
2021-11-03
Dose 2 — Moderna
-
2021-11-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-11-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-11-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-11-07
- 2021-11-08
- 2021-11-09
- 2021-11-11
- 2021-11-17
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2021-11-24
Survey response — day 21, dose 2MedDRA: Fatigue, Lacrimation increased, Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea — Feeling: FairFree text: Cold symptoms such as runny nose, congestion, watery eyes, fatigueMedDRA releases: 2024-11 · check-in free text available
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2022-02-02
- 2022-05-04
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2022-11-03
Survey response — 12 months, dose 2MedDRA: Cough, Nasopharyngitis — Feeling: GoodFree text: Previous alleged cold (no testing) and lingering coughMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-10-05 | Moderna | No |
| 2 | 2021-11-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-19 | Unsuccessful |
Free text
Release 10 — day 7, dose 1
Systemic reaction (other): Slight cough
Release 10 — day 14, dose 1
Symptoms: I came down with Covid symptoms 10/13 and tested positive 10/14. Symptoms were severe body aches, chills, fatigue, congestion and sinus pain, high heart rate, mild cough.
Release 10 — day 21, dose 2
Symptoms: Cold symptoms such as runny nose, congestion, watery eyes, fatigue
Release 12 — 12 months, dose 2
Symptoms: Previous alleged cold (no testing) and lingering 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 | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Heart rate increased | · | · | ✓ |
| SD | Lacrimation increased | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinus pain | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release