XUA-68163-70689
2 vaccinations
8 coded responses
17 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 117 / NY
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-11
Registered in v-safe
-
2021-01-11
Survey response — days 1–6 daily, dose 1MedDRA: Hypoaesthesia, Pain, Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-01-11
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-01-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-13
-
2021-01-14
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal pain — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-18
- 2021-01-22
- 2021-01-29
- 2021-02-05
-
2021-02-08
Dose 2 — Moderna
-
2021-02-19
Survey response — 7 day, dose 2MedDRA: Chills, Headache, Nausea, Pain, Pyrexia, Rash — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-22
-
2021-02-24
Survey response — 14 day, dose 2MedDRA: Dizziness, Fatigue, Rash — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-01
-
2021-03-10
Survey response — 28 day, dose 2MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-15
Survey response — 35 day, dose 2MedDRA: Headache — Feeling: Fair · Be unable to workMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-22
- 2021-05-12
-
2021-08-11
Survey response — 6 month, dose 2MedDRA: Cough, Nasal congestion, Nasopharyngitis, Sneezing — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2024-11 · check-in answers available
-
2022-02-08
Survey response — 12 month, dose 2MedDRA: Arthralgia, Headache, Swelling — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-08 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-11 | Unsuccessful |
Free text
Release 1
Systemic reaction (other): Shooting pain down arm and some numbness in fingers
Release 2
Systemic reaction (other): Slight sore throat
Release 4
Systemic reaction (other): Within 6 hours after the vaccine was administered, I was running a fever, had severe chills, headache, body ache and nausea. This lasted for 2 days. I had a moderate headache, severe body ache, and severe fatigue every day since the shot. The rash on my trunk and legs developed about 4 days after the injection.
Symptoms: Dizziness that comes and goes/Fatigue/rash on legs
Release 5
Symptoms: Headaches
Symptoms: Headaches have continued but seem to be less painful than last week.
Release 9
Symptoms: Symptoms like a cold. Stuffy nose, some coughing, sneezing that only lasted about 2-3 days.
Release 11
Symptoms: Headaches, joint pain, swelling
Free-text releases are not linked to a specific 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 | Arthralgia | · | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | · | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Sneezing | ✓ | · | ✓ |
| SD | Swelling | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release