XUX-22596-19786
5 vaccinations
4 coded responses
25 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 549 / WI
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Registered in v-safe
-
2021-01-06
Dose 1 — Moderna
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-13
-
2021-01-21
Survey response — 14 day, dose 1MedDRA: Myalgia — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-27
- 2021-02-03
-
2021-02-06
Dose 2 — Moderna
- 2021-02-17
- 2021-02-20
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
-
2021-05-08
Survey response — 3 month, dose 2MedDRA: Decreased activity, Dyspnoea, Palpitations, Pre-existing disease — Feeling: Good · 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
-
2021-05-08
Report sent to call center — 3 month, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-07
Survey response — 6 month, dose 2MedDRA: Dizziness, Dyspnoea, Exercise tolerance decreased, Palpitations, Pre-existing disease — Feeling: Good · 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: 2021-09,2024-11 · check-in answers available
-
2021-08-07
Report sent to call center — 6 month, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-15
-
2021-08-19
Call successfulParticipant prefers to complete VAERS report online
-
2021-08-19
Call successfulParticipant prefers to complete VAERS report online
-
2021-11-03
Dose 3 — Moderna
- 2022-02-06
-
2022-05-18
Dose 4 — Pfizer-BioNTech
-
2022-10-06
Dose 5 — Moderna
- 2022-10-24
- 2022-10-27
- 2022-11-05
- 2022-11-10
-
2022-11-17
Survey response — 42 day, dose 5MedDRA: Hypertension, Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11 · check-in answers available
-
2022-11-17
Report sent to call center — 42 day, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-18
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 | 2021-01-06 | Moderna | |
| 2 | 2021-02-06 | Moderna | |
| 3 | 2021-11-03 | Moderna | No |
| 4 | 2022-05-18 | Pfizer-BioNTech | No |
| 5 | 2022-10-06 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-08 | Successful 2021-08-19 |
Participant prefers to complete VAERS report online |
| 2021-08-07 | Successful 2021-08-19 |
Participant prefers to complete VAERS report online |
| 2022-11-17 | Successful 2022-11-18 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 2
Symptoms: Left hip pain. I feel it is muscular in nature. May be exercise related, but I cannot identify a causal event.
Release 8
Symptoms: Increased heart palpitations. I do have this issue, but in Mid March for3 weeks, I experienced increased palpitations, decreased ability to run without getting short of breath and general decrease in wellbeing. I am now recovered.
Release 9
Symptoms: From 3/5/21 - mid April, my ability to run decreased significantly. SOB, heart palpitations (history of PVCs & PACs) and dizziness of increased severity. Many tests resulted normal. By June, I was able to begin to run well. VO2 returned to normal.
Release 12
Symptoms: Heart palpitations- worsening; increased high blood pressure
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 | Decreased activity | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | · | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Exercise tolerance decreased | ✓ | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Palpitations | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release