XL8-43004-97128
2 vaccinations
3 coded responses
27 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 403 / KY
- Registered
- 2021-04-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-15
Registered in v-safe
-
2021-04-15
Dose 1 — Moderna
- 2021-04-15
-
2021-04-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-17
- 2021-04-18
- 2021-04-19
-
2021-04-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Chills, Fatigue or tirednessAdult check-in
-
2021-04-22
Health check-in — day 7, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-29
Survey response — day 14, dose 1MedDRA: Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: HeadacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
-
2021-07-27
Dose 2 — Moderna
-
2021-07-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-07-29
- 2021-07-30
- 2021-07-31
-
2021-08-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-08-02
- 2021-08-03
- 2021-08-11
- 2021-08-17
- 2021-08-24
- 2021-08-31
- 2021-09-07
- 2021-10-26
-
2022-01-26
Survey response — 6 months, dose 2MedDRA: Noninfective gingivitis — Feeling: PoorFree text: Sores on gumsMedDRA releases: 2024-11 · check-in free text available
-
2022-08-01
Survey response — 12 months, dose 2MedDRA: Attention deficit hyperactivity disorder, Depression, Executive dysfunction, Memory impairment — Feeling: Poor · Be unable to work or attend school, 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: Adhd, memory problems, executive function problems, depression,MedDRA releases: 2024-11 · check-in free text available
-
2022-08-01
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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-08-02
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-15 | Moderna | |
| 2 | 2021-07-27 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-08-01 | Successful 2022-08-02 |
Participant prefers to complete VAERS report online |
Free text
Release 8 — day 14, dose 1
Symptoms: Headache
Release 11 — 6 months, dose 2
Symptoms: Sores on gums
Release 12 — 12 months, dose 2
Symptoms: Adhd, memory problems, executive function problems, depression,
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 | Attention deficit hyperactivity disorder | · | · | ✓ |
| SD | Depression | · | · | ✓ |
| SD | Executive dysfunction | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Memory impairment | · | · | ✓ |
| SD | Noninfective gingivitis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release