QLW-33997-41910
4 vaccinations
5 coded responses
43 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 949 / CA
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Registered in v-safe
-
2021-01-06
Dose 1 — Moderna
- 2021-01-06
-
2021-01-07
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
-
2021-01-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-09
- 2021-01-10
- 2021-01-12
- 2021-01-13
- 2021-01-20
- 2021-01-27
-
2021-02-03
Dose 2 — Moderna
-
2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Aphthous ulcer — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-06
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate irregular, Hypertension — Feeling: Good · Chills · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
-
2021-10-25
Dose 3 — Moderna
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Joint pains, NauseaAdult check-in
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-15
Dose 4 — Moderna
- 2022-04-15
-
2022-04-16
Survey response — days 1–6 daily, dose 4MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
-
2022-04-17
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-04-18
Survey response — days 1–6 daily, dose 4MedDRA: Tinnitus — Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
-
2022-04-19
Health check-in — days 1–6 daily, dose 4Feeling: Good · Joint pains, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-20
- 2022-04-21
- 2022-04-22
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
-
2022-05-27
Survey response — 42 day, dose 4MedDRA: Condition aggravated, Extrasystoles, Pre-existing disease, Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11 · check-in answers available
-
2022-05-27
Report sent to call center — 42 day, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-06-01
-
2022-06-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-15 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-27 | Successful 2022-06-01 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 3
Systemic reaction (other): Canker sores came out.
Systemic reaction (other): Rapid heart rate and higher blood pressure
Release 11
Systemic reaction (other): Ringing in ears
Systemic reaction (other): Ringing in ears
Symptoms: Ringing in ears, ectopic heart beats (autoimmune response I get when my Hashimotos thyroid issue flares). Ringing in ears is likely from vaccine (got it with my first booster as well).
Free-text releases are not linked to a specific 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 | Condition aggravated | · | · | ✓ |
| SD | Extrasystoles | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SRO | Aphthous ulcer | ✓ | ✓ | ✓ |
| SRO | Heart rate irregular | ✓ | ✓ | ✓ |
| SRO | Hypertension | ✓ | ✓ | ✓ |
| SRO | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release