XHS-19496-12097
2 vaccinations
3 coded responses
17 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 531 / WI
- Registered
- 2021-06-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-06-10
Registered in v-safe
-
2021-06-10
Dose 1 — Moderna
- 2021-06-10
-
2021-06-11
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body aches, DiarrheaAdult check-in
-
2021-06-12
Survey response — days 1–6 daily, dose 1MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Had a pleurisy/costochondritis flare up start late yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-12
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-13
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2021-06-15
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-06-15
- 2021-06-16
-
2021-07-08
Dose 2 — Moderna
-
2021-07-08
Survey response — day 0, dose 2MedDRA: Dizziness — Feeling: Good · Site: PainFree text: Slight dizziness, lightheadednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
-
2021-07-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2021-07-11
- 2021-07-12
- 2021-07-14
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2021-07-16
Survey response — day 7, dose 2MedDRA: Back pain, Chest pain, Neck pain — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Currently experiencing back chest and neck pain, which works when breathing deeply.MedDRA releases: 2024-11 · check-in free text available
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2021-07-16
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-19
- 2021-07-29
- 2021-08-12
- 2021-08-21
- 2022-01-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-10 | Moderna | |
| 2 | 2021-07-08 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-12 | Unsuccessful | |
| 2021-07-16 | Unsuccessful |
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Had a pleurisy/costochondritis flare up start late yesterday
Release 9 — day 0, dose 2
Systemic reaction (other): Slight dizziness, lightheadedness
Release 9 — day 7, dose 2
Systemic reaction (other): Currently experiencing back chest and neck pain, which works when breathing deeply.
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 |
|---|---|---|---|---|
| SRO | Back pain | · | · | ✓ |
| SRO | Chest pain | · | · | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Neck pain | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release