XRB-19016-92863
4 vaccinations
5 coded responses
39 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 787 / TX
- Registered
- 2020-12-29
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-29
Registered in v-safe
-
2020-12-29
Dose 1 — Moderna
- 2020-12-29
-
2020-12-30
Survey response — days 1–6 daily, dose 1MedDRA: Feeling hot — Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessFree text: WarmMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
-
2021-01-12
Survey response — day 14, dose 1MedDRA: Injection site hypersensitivity, Injection site rash, Injection site swelling — Feeling: GoodFree text: Rash/allergic swelling reaction symptoms at injection site 8 days after first vaccine doseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-20
-
2021-01-26
Dose 2 — Moderna
- 2021-01-26
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-01-28
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-04-27
- 2021-07-27
-
2021-10-30
Dose 3 — Moderna
- 2022-01-31
-
2022-09-16
Dose 4 — Moderna
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-21
-
2022-09-22
Survey response — days 1–6 daily, dose 4MedDRA: Oropharyngeal pain, Rhinorrhoea, Unevaluable event — Feeling: Good · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Runny nose, sore throat · Healthcare visit (other): Pcr testMedDRA releases: 2024-11 · check-in free text available
-
2022-09-22
Report sent to call center — days 1–6 daily, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
-
2022-09-23
Survey response — day 7, dose 4MedDRA: Nasal congestion — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Nasal congestionMedDRA releases: 2024-11 · check-in free text available
- 2022-09-23
-
2022-09-23
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
-
2022-10-28
Survey response — day 42, dose 4MedDRA: Cough, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Cold coughMedDRA releases: 2024-11 · check-in free text available
- 2022-12-16
- 2023-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-29 | Moderna | |
| 2 | 2021-01-26 | Moderna | |
| 3 | 2021-10-30 | Moderna | No |
| 4 | 2022-09-16 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-09-22 | Successful 2022-09-23 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Warm
Release 1 — day 14, dose 1
Symptoms: Rash/allergic swelling reaction symptoms at injection site 8 days after first vaccine dose
Release 12 — days 1–6 daily, dose 4
Release 12 — day 7, dose 4
Systemic reaction (other): Nasal congestion
Release 12 — day 42, dose 4
Symptoms: Cold cough
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 | Unevaluable event | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Injection site hypersensitivity | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release