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XUL-13566-82372

2 vaccinations 7 coded responses 15 check-ins 7 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
931 / CA
Registered
2021-04-10
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-12
    Dose 1 — Moderna
  2. 2021-04-09
    Dose 2 — Moderna
  3. 2021-04-10
    Registered in v-safe
  4. 2021-04-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  5. 2021-04-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  6. 2021-04-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Atrial fibrillation, Dyspnoea, Vaccine positive rechallenge — Feeling: Poor · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  7. 2021-04-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Atrial fibrillation — Feeling: Fair
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  8. 2021-04-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Atrial fibrillation — Feeling: Good · Fatigue or tiredness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  9. 2021-04-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Atrial fibrillation, Pre-existing disease — Feeling: Good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  10. 2021-04-16
    Health check-in — 7 day, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-04-24
    Survey response — 14 day, dose 2
    MedDRA: Atrial fibrillation — Feeling: Good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  12. 2021-05-01
    Health check-in — 21 day, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-05-09
    Health check-in — 28 day, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-05-15
    Health check-in — 35 day, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-05-23
    Survey response — 42 day, dose 2
    MedDRA: Biopsy, Biopsy breast — Feeling: Good · Get care from a doctor or other healthcare professional
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  16. 2021-05-23
    Report sent to call center — 42 day, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-07-11
    Health check-in — 3 month, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-10-09
    Health check-in — 6 month, dose 2
    Feeling: Good
    Adult check-in
  19. 2022-04-07
  20. 2022-04-14
    Survey response — 12 month, dose 2
    MedDRA: Hospitalisation, Malaise, Sepsis, Urinary tract infection — Feeling: Good · Be unable to work or attend school, 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 visit, Emergency room or emergency department visit, Hospitalization
    MedDRA releases: 2024-11 · check-in answers available
  21. 2022-04-14
    Report sent to call center — 12 month, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
  22. 2022-04-19
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-03-12Moderna
22021-04-09Moderna

Call center

ReportedOutcomeVAERS-related outcome
2021-05-23 Successful Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-14 Successful
2022-04-19
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7

Systemic reaction (other): Afib is back happened with 1st shot as well this time worse been going on since w days ago last time completely stopped by 3rd day.also short of breath. If continues will contact my dr

Systemic reaction (other): Still hVe AFIB

Systemic reaction (other): Afib is still happening i had none before shot seeing dr soon

Systemic reaction (other): Afib continues

Symptoms: Afib is continuing

Release 8

Symptoms: Had to have breast biopsy which was false undoubtably caused by vaccine effects!!!!
Healthcare visit (other): Biopsy

Release 11

Symptoms: I was hospitalized with Sepsis. I was very sick it was from a UTI.

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

FieldPreferred term2021-092023-042024-11
HCVOBiopsy ✓ ✓ ✓
SDAtrial fibrillation ✓ ✓ ✓
SDBiopsy breast ✓ ✓ ✓
SDHospitalisation · · ✓
SDMalaise · · ✓
SDSepsis · · ✓
SDUrinary tract infection · · ✓
SROAtrial fibrillation ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROVaccine positive rechallenge ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release