XV4-38681-54195
5 vaccinations
4 coded responses
46 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 498 / MI
- Registered
- 2021-02-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-11
Dose 1 — Moderna
-
2021-02-12
Registered in v-safe
-
2021-02-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-25
- 2021-03-04
-
2021-03-11
Dose 2 — Moderna
- 2021-03-11
-
2021-03-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
- 2021-04-03
-
2021-04-08
Survey response — 28 day, dose 2MedDRA: Pre-existing disease, Rash — Feeling: Fair · 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
-
2021-04-08
Report sent to call center — 28 day, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-15
Survey response — 35 day, dose 2MedDRA: Rash — Feeling: FairMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-04-24
- 2021-06-10
- 2021-09-09
-
2021-10-25
Dose 3 — Moderna
- 2021-10-28
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
-
2022-01-24
Survey response — 3 month, dose 3MedDRA: Office visit, Rash, Rash erythematous — 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
-
2022-01-24
Report sent to call center — 3 month, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-01-25
Call successfulDoes not wish to fill out VAERS report
- 2022-04-25
-
2022-05-02
Dose 4 — Moderna
-
2022-10-17
Dose 5 — ModernaCo-administered: Flu
-
2022-10-21
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-22
-
2022-10-23
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2022-11-21
- 2022-11-28
-
2023-01-16
Survey response — 3 month, dose 5MedDRA: Respiratory syncytial virus infection — 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: 2024-11 · check-in answers available
-
2023-01-16
Report sent to call center — 3 month, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-17
- 2023-04-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-11 | Moderna | |
| 2 | 2021-03-11 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-05-02 | Moderna | No |
| 5 | 2022-10-17 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-08 | Successful | Does not wish to fill out VAERS report |
| 2022-01-24 | Successful 2022-01-25 |
Does not wish to fill out VAERS report |
| 2023-01-16 | Unsuccessful |
Free text
Release 7
Symptoms: Rash like poison oak on my hand and arm. Right hand worse than left. Looks like an allergic reaction. Don't know where I could have gotten it. No direct contact to brush that I am aware of.
Symptoms: My rash on hands and arms is better, but the rash has appeared on my lower leg calves and ankles.
Release 11
Symptoms: Red bumps on arms and legs occurred 2 weeks after booster. Don't know if it's related or not. My doctor didn't know what it was. It's better now.
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 | Office visit | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ○ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash erythematous | · | · | ✓ |
| SD | Respiratory syncytial virus infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release