XQD-19655-76533
3 vaccinations
4 coded responses
29 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 926 / CA
- Registered
- 2021-05-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-18
Dose 1 — Moderna
-
2021-05-18
Registered in v-safe
-
2021-05-18
Dose 2 — Moderna
-
2021-05-18
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain, Itching · Headache, NauseaAdult check-in
-
2021-05-19
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-05-20
Survey response — days 1–6 daily, dose 2MedDRA: Dyspnoea — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, 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: Shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-20
Report sent to call center — days 1–6 daily, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-05-21
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · Fever · NoneAdult check-in
- 2021-05-22
- 2021-05-23
- 2021-05-24
- 2021-05-27
- 2021-06-01
- 2021-06-10
- 2021-06-15
- 2021-06-22
- 2021-06-29
- 2021-08-19
- 2021-11-18
-
2022-01-23
Dose 3 — Moderna
-
2022-01-24
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-01-25
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: Poor · Site: Pain · Headache, Muscle or body aches · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: My underarm on the arm that received the shot feels swollen and extremely painful even when the arm is at restMedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
-
2022-01-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
-
2022-01-28
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain — Feeling: Fair · Muscle or body achesFree text: Lymph node in armpit and shoulder still feels sore but not too badMedDRA releases: 2024-11 · check-in free text available
- 2022-01-29
- 2022-01-30
- 2022-02-06
- 2022-02-15
-
2022-02-20
Survey response — day 28, dose 3MedDRA: Abortion spontaneous — Feeling: FairFree text: I had a miscarriageMedDRA releases: 2024-11 · check-in free text available
- 2022-03-01
- 2022-03-08
- 2022-04-26
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2022-05-10
Call successfulCompleted over the phone
- 2023-01-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-18 | Moderna | |
| 2 | 2021-05-18 | Moderna | |
| 3 | 2022-01-23 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-20 | Successful 2022-05-10 |
Completed over the phone |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Shortness of breath
Release 11 — days 1–6 daily, dose 3
Systemic reaction (other): My underarm on the arm that received the shot feels swollen and extremely painful even when the arm is at rest
Systemic reaction (other): Lymph node in armpit and shoulder still feels sore but not too bad
Release 11 — day 28, dose 3
Symptoms: I had a miscarriage
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 | Abortion spontaneous | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release