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UV4-13141-89768

2 vaccinations 4 coded responses 18 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
31-35
ZIP prefix
973 / OR
Registered
2021-01-09
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
K9X-24326-27703 Child or adolescent in my care · Male · 2022-07-09

Timeline

  1. 2021-01-09
    Registered in v-safe
  2. 2021-01-09
    Dose 1 — Moderna
  3. 2021-01-09
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain, Itching · Fatigue or tiredness
    Adult check-in
  4. 2021-01-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  5. 2021-01-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  6. 2021-01-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  7. 2021-01-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  8. 2021-01-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-01-23
    Survey response — day 14, dose 1
    MedDRA: Induration, Lymph node pain, Lymphadenopathy, Vaccination site erythema, Vaccination site induration, Vaccination site pruritus, Vaccination site rash, Vaccination site warmth — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: On day 7 after vaccination I woke up with a new red, hard, rash at the vaccination site. It was very hot to the touch and extremely itchy. I also noticed swolken lymph nodes near my left under arm area that are hardened and painful
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-01-23
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  11. 2021-01-30
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  12. 2021-02-06
    Health check-in — day 28, dose 1
    Feeling: Fair
    Adult check-in
  13. 2021-02-07
    Dose 2 — Moderna
  14. 2021-02-14
    Health check-in — day 7, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · None
    Adult check-in
  15. 2021-02-21
    Survey response — day 14, dose 2
    MedDRA: Chills, Fatigue, Migraine — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Had chills and migraine headache. Also moderate fatigue about 2 days poat 2nd vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-28
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-03-07
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-14
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-03-21
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-04-01
  21. 2021-05-09
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-08-10
    Survey response — 6 months, dose 2
    MedDRA: Influenza like illness, Sinusitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Sinus infection and some flu like symptom
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  23. 2022-02-07
    Survey response — 12 months, dose 2
    MedDRA: Office visit, Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Pregnancy · Healthcare visit (other): Check up with OBGYN
    MedDRA releases: 2024-11 · check-in free text available
  24. 2022-02-07
    Report sent to call center — 12 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  25. 2022-02-11

Vaccinations

DoseDateManufacturerCo-administered
12021-01-09Moderna
22021-02-07Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-01-23 Unsuccessful
2022-02-07 Unsuccessful

Free text

Release 2 — day 14, dose 1

2021-01-23

Symptoms: On day 7 after vaccination I woke up with a new red, hard, rash at the vaccination site. It was very hot to the touch and extremely itchy. I also noticed swolken lymph nodes near my left under arm area that are hardened and painful

Release 4 — day 14, dose 2

2021-02-21

Symptoms: Had chills and migraine headache. Also moderate fatigue about 2 days poat 2nd vaccine

Release 9 — 6 months, dose 2

2021-08-10

Symptoms: Sinus infection and some flu like symptom

Release 11 — 12 months, dose 2

2022-02-07

Symptoms: Pregnancy
Healthcare visit (other): Check up with OBGYN

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
HCVOOffice visit · · ✓
SDChills ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDInduration ✓ ✓ ✓
SDInfluenza like illness ✓ · ✓
SDLymph node pain ✓ ✓ ✓
SDLymphadenopathy ✓ ✓ ✓
SDMigraine ✓ ✓ ✓
SDPregnancy · · ✓
SDSinusitis ✓ · ✓
SDVaccination site erythema ✓ ✓ ✓
SDVaccination site induration ✓ ✓ ✓
SDVaccination site pruritus ✓ ✓ ✓
SDVaccination site rash ✓ ✓ ✓
SDVaccination site warmth ✓ ✓ ✓

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