UCV-24507-11069
2 vaccinations
3 coded responses
15 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 915 / CA
- Registered
- 2021-01-02
- Relationship
- Self
- Race
- Other
- Ethnicity
- Hispanic or Latino
Timeline
-
2020-12-30
Dose 1 — Moderna
-
2021-01-02
Registered in v-safe
-
2021-01-02
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: Good · Site: Pain · Be unable to do your normal daily activitiesFree text: fatigue about 6 hrs after the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-02
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-06
- 2021-01-13
- 2021-01-20
- 2021-01-27
-
2021-02-01
Dose 2 — Moderna
-
2021-02-03
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: These symptoms were experienced in 2/2/21MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-15
-
2022-02-01
Survey response — 12 months, dose 2MedDRA: COVID-19, Chills, Dyspnoea, Fatigue, Fluid replacement, Headache, Pyrexia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: Covid : chills , fever , headache , extreme fatigue , SOB · Healthcare visit (other): At home IV hydrationMedDRA releases: 2024-11 · check-in free text available
-
2022-02-01
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-02-02
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-02-01 | Moderna |
Call center
2 call center cases
1 successful · 1 priority 2/3 (triaged and no follow up)
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): fatigue about 6 hrs after the vaccine
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): These symptoms were experienced in 2/2/21
Release 11 — 12 months, dose 2
Symptoms: Covid : chills , fever , headache , extreme fatigue , SOB
Healthcare visit (other): At home IV hydration
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 |
|---|---|---|---|---|
| HCVO | Fluid replacement | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release