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
-
2021-03-12
Dose 1 — Moderna
-
2021-04-09
Dose 2 — Moderna
-
2021-04-10
Registered in v-safe
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-04-11
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Atrial fibrillation, Dyspnoea, Vaccine positive rechallenge — Feeling: Poor · Site: Redness, Swelling, Itching · Joint pains, Muscle or body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Atrial fibrillation — Feeling: FairMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-14
Survey response — days 1–6 daily, dose 2MedDRA: Atrial fibrillation — Feeling: Good · Fatigue or tirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Atrial fibrillation, Pre-existing disease — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-16
-
2021-04-24
Survey response — 14 day, dose 2MedDRA: Atrial fibrillation — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-05-01
- 2021-05-09
- 2021-05-15
-
2021-05-23
Survey response — 42 day, dose 2MedDRA: Biopsy, Biopsy breast — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-05-23
Report sent to call center — 42 day, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-11
- 2021-10-09
- 2022-04-07
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2022-04-14
Survey response — 12 month, dose 2MedDRA: 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, HospitalizationMedDRA releases: 2024-11 · check-in answers available
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2022-04-14
Report sent to call center — 12 month, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-04-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna | |
| 2 | 2021-04-09 | Moderna |
Call center
| Reported | Outcome | VAERS-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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Biopsy | ✓ | ✓ | ✓ |
| SD | Atrial fibrillation | ✓ | ✓ | ✓ |
| SD | Biopsy breast | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Sepsis | · | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Atrial fibrillation | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release